When Amy's puppy misbehaves, her mother's boyfriend gets a pillowcase and threatens to kill him. Amy tries to run away with the puppy, but the boyfriend catches her. He puts the puppy into the pillowcase and throws him into a river. Amy is crying and very upset. She even jumps in to save the dog. She is hospitalized briefly, but she and the puppy are both okay.
Julia has a few "episodes" as a result of her genetic illness. She is hospitalized sometimes, too. It can be frightening for some younger viewers.