Labrador retriever’s prognosis good after hemodialysis treatment at UF

Cotton, a 4-year-old yellow Labrador, led a fairly cosmopolitan, stress-free life up until August. She summered in the Bahamas. She was comfortable on a boat, in a truck or in a tractor in Pass Christian, Miss., on the Gulf Coast, where she frequently spent time with her owner’s parents. She had adjusted to city life quite well after following her owner, Mary Keith “Keith” Puckett, from Starkville, Miss., to her new job in Dallas.

But it was in the idyllic community of Hope Town, Abaco, Bahamas, that Cotton suddenly grew deathly ill.

“At first, it didn’t seem too serious, but we took her to the local vet in Marsh Harbour, and after two afternoons of treatment, we decided she needed more help,” said Keith’s mother, Mary Lee Puckett, adding that her veterinarian in Pass Christian, Jennifer Hendrick, D.V.M., had recommended taking Cotton back to the U.S. for critical diagnostic testing.

What happened next involved an odyssey of veterinary consultations and referrals, ultimately leading Cotton to the University of Florida Small Animal Hospital to receive lifesaving dialysis after being diagnosed with kidney failure.

On Aug. 7, Keith’s father, Ben Puckett, arranged for a charter flight to transport his daughter, wife and Cotton to Fort Lauderdale. With a stop at Acacia Animal Hospital in Pompano Beach, Cotton was then referred to PetPB Animal Emergency Center in Boynton Beach, where an internist, Bettina Mayer-Roenne, D.V.M., immediately recognized that the dog was a good candidate for hemodialysis treatment.

“She said the sooner the better, called UF and arranged for our arrival after midnight, even printing out phone numbers and driving directions,” Mary Lee Puckett said. “By then, my husband, Ben, had arrived, and he drove us rather rapidly up to Gainesville. Cotton was so sick at that point, and we were frantic.”

Cotton was able to receive care immediately after arriving in Gainesville at 1 a.m. through the UF Small Animal Hospital’s 24-hour emergency service. The family was met by Katie Baxter, B.V.Sc., a third-year small animal medicine resident, Jordan Nickell, D.V.M., an intern with the emergency and critical care service, and Theresa Rodina, a junior veterinary student.

Baxter said she was encouraged by the fact that Cotton was a young dog and had been referred to UF quickly enough that clinicians could be proactive in their treatment.

Cotton received two five-hour hemodialysis treatments, one the day of her arrival and another two days later.

“When a case is very severe, we will perform hemodialysis daily initially, but in Cotton’s case, we were able to do the treatments two days apart,” Baxter said.

Within days, Cotton’s blood values had improved. For another week, however, she remained at UF while Baxter and Carsten Bandt, D.V.M., an assistant professor and head of the UF Small Animal Hospital’s hemodialysis unit, monitored her liver and kidney function. Although Keith Puckett had returned to work in Dallas, for the next 10 days, Ben and Mary Lee Puckett were frequent visitors to the hospital.

“Our lives at this point revolved around when we could visit Cotton,” Mary Lee Puckett said. “Dr. Baxter was so kind, and made sure she or Jessica Scott, our next student, called us several times during the day to let us know Cotton’s condition and when we could come for a visit. We often looked like a parade when Dr. Baxter, Jessica, my husband Ben, Cotton and I would all head outside so Cotton could get some fresh air.

“This required one to hold the leash, one to hold the catheter bag, one to hold the food we were trying to tempt her with and one to open doors,” Mary Lee Puckett added. “They kindly performed this act a couple of times a day with compassion and a sense of humor.”

On Aug. 23, the Pucketts received the go-ahead from UF to take Cotton home to Pass Christian. UF clinicians say she has a very good prognosis, although they were never able to determine the cause of her illness. Preliminary tests for leptospirosis came back negative, and clinicians say the problem could have been caused by heatstroke or by some type of toxin.

“We may never find out what it was,” Baxter said. “In about half of the dogs with renal failure, the cause is never determined.”

As for the Pucketts, they were happy to finally be able to take Cotton home, after two and a half weeks of uncertainty.

“Our family so appreciates everyone who touched Cotton’s life, from the friendly receptionists to all of the veterinary students, including our last student, Nicki Puza, all of the students in ICU and all of the technicians, specifically Andrea Shultz from the hemodialysis team,” Mary Lee Puckett said. “We are overwhelmed by Dr. Baxter’s expertise and are so indebted to her for her selfless consideration of her patients and their families, and are thankful for Dr. Bandt’s skilled knowledge of dialysis. We are huge fans of the UF Veterinary Hospitals, and are so pleased that Cotton was able to be treated there.”