Team effort saves dog's life at Veterinary Teaching Hospital
The energetic dog they knew was fading.
Weakness, labored breathing, and collapse had set in, turning Joseph and Mary Carucci's lives into a frantic search for help for Pasha, a 4-year-old shepherd mix they rescued from Turkey.
"She was gone," Joseph Carucci said, recalling the memory of Pasha's critical state. "We were sitting there ... pretty much saying our goodbyes."
A frightening decline
Pasha had been treated for intermittent, puzzling health issues since settling in with the Carucci family in Boones Mill. The cause of these “weird episodes” remained a mystery.
Acting on a friend's urgent recommendation, they made the hour-long drive to the Veterinary Teaching Hospital at Virginia Tech.
Pasha arrived in shock, her body unable to maintain safe blood pressure and blood sugar levels. In the high-pressure environment of emergency medicine, quickly identifying the exact cause of such a critical state is vital.
The team, including Laura Vega, clinical assistant professor in the Virginia-Maryland College of Veterinary Medicine, immediately began intensive treatment while seeking a diagnosis.
After initial stabilization measures fell short, Vega decided to test for adrenal insufficiency, also known as Addison's disease, a condition that wasn't immediately obvious among the possibilities.
Tests confirmed this diagnosis – Pasha's body wasn't making enough cortisol, a hormone needed to handle stress and keep blood pressure and body systems stable. This finding was a crucial piece of the puzzle, explaining why her body likely collapsed so severely.
Still, the mystery wasn't fully solved. Chest X-rays showed unusual patterns in Pasha's lungs, suggesting a separate respiratory issue that added another layer to the medical picture.
“Typically, untreated Addison's alone can be enough to make a patient crash, but sweet Pasha was up against even more than that,” Vega said. “Having said that, testing her for that cortisol deficiency and getting her some supplementation was a turning point in her recovery.”
A team effort
"It was a lot of collaboration," Vega said. "I love being able to talk with my colleagues and say, ‘I have all the pieces, but I can’t quite fit them together, let’s figure this out.’”
Pasha's treatment required the expertise of many specialists, including the internal medicine and radiology teams, as well as support from veterinary students and the emergency and critical care veterinary technicians.
The family was struck by the team's composure. “One of the most amazing things for me was when Vega was explaining her thought process – why she was doing each test and what to expect – it was so impressive,” Carucci said.
He compared Vega's treatment to the television medical drama “House.”
Carucci said he also remembers Rebecca Persons, clinical instructor of community practice, another clinician on the case, working to stabilize Pasha. Her calm, decisive demeanor reminded him of a battlefield or incident commander. "She was nothing short of amazing," he said.
“It takes a certain type of mentality, a certain type of temperament to handle crisis situations where everything's coming in at you once.”
For veterinary students, witnessing this collaboration is invaluable.
"Cases like this show how everything is interconnected," recent graduate Sydney Boo said. Boo worked on Pasha’s case as one of her final experiences during her clinical year. “And Pasha is so cute, I love her. She’s literally the best.”
The experience reinforced her own career goals – she is heading to a rotating internship in Washington, D.C., with plans of becoming a cardiologist.
“I’m also interested in internal medicine,” Boo said. “I wasn’t at first, but after this block, I really am.”
The road to recovery
Pasha recovered in the intensive care unit, charming everyone she encountered. "She’s all kisses, even when you’re trying to examine or treat her," Vega said.
After three days, Pasha was discharged to continue her recovery at home. Her transformation there was dramatic.
"She hasn't been this active since she was a puppy," Carucci said. "Her sweet personality is back to what it was.”
Even a strange, long-standing odor around Pasha had vanished, a curious potential sign of improvement. "It's gone," Carucci said.
While Pasha was thriving at home, her care continued. A follow-up appointment with the internal medicine service provided important updates for Pasha's ongoing management.
Repeat X-rays showed Pasha's lungs were clear, and bloodwork confirmed the inflammation had resolved. This supports the idea that she was also dealing with a condition called eosinophilic bronchopneumopathy.
While Pasha will need lifelong medication to manage her Addison's, she is expected to thrive.
“Normally in emergency, we see ‘new’ issues,” Vega said. “So being able to uncover something that was affecting Pasha chronically and work with colleagues to not only save her but improve her quality of life going forward is so gratifying.”
Beyond the advanced medical care and collaborative expertise, the Caruccis were moved by the warmth shown by the Virginia Tech team.
"Sometimes in the medical profession, people can become detached," Carucci said. "You didn't see that here. They cared about every patient that was in front of them, especially Pasha."
