 TOA
PAYOH VETS
toapayohvets.com
Date:
01 November, 2013
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Focus: Small
animals - dogs, cats, hamsters, guinea pigs, turtles & rabbits |
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A young Pom cannot stand or walk on 4 legs
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:
01 November, 2013
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 toapayohvets.com
Be Kind To Pets
Veterinary Education
Project 2010-0129 |
Oct 1, 2013
The care-giver brought
in a 7-month-old Pom,
not able to stand at
all. The couple had
volunteered to care
for this dog as her
lady owner's apartment
was being renovated
and this would take
some time.
Vet 1 had seen her
twice and had given
meloxicam oral at the
first visit. At the
2nd visit, tramadol
oral was prescribe and
a buprenorphine
injection was given as
pain-killers. Vet 1
suspected that
salivation was due to
oral meloxicam and
advised stopping the
medication..
As the dog had
pain-killers, it was
difficult to find the
source of pain. Spinal
palpation elicited
some pain in the T/L
area and the dog cried
when her left hind was
extended for the
X-rays.
Oct 2, 2013
This morning, the dog
was not able to become
upright when laid
sideways to the left
and to the
right. However she
could sit on her
sternum. The pedal
reflexes of 4
limbs were poor, esp.
left fore and right
hind. Shining a light
constricted both
pupils. I palpated
from the neck to the
tail spinal area. The
dog screamed at the
spinal area between
the neck and the
shoulder blade. I had
this scene videoed.
What was the problem?
Would the dog recover?
The caregiver was
worried and so was the
owner. This was a
young dog and she
could not walk or
stand. When laid
sideways to the left
and to the right, she
could not upright
herself. I videoed
this behaviour. This
was worrisome as there
seemed to be a very
serious injury of the
brain or upper spinal
cord. I phoned Vet 1
for the medical
records. Only
pain-killers were
given orally and one
was injected. No blood
test or X-rays were
done. As the dog
salivated, the
care-givers brought
the dog to consult me
since I had treated
their dog with
difficulty in
breathing successfully
curing it within 2
days. It is not every
dog that I treat
recover within 2 days
and this case was
probably a mild upper
respiratory
infection.
Unfortunately, pet
owners judge the vet's
expertise by the speed
of recovery and this
is not right.
After videoing, I gave
this dog a
subcutaneous injection
of saline, glucose and
amino acids and
anti-inflammatory and
antibiotics, expecting
no response.
BLOOD TEST & VISIT BY
THE OWNER ON OCTOBER
2, 2013
"It is best to take a
blood test to check
whether there is any
infection causing this
ataxia," I advised the
owner who came in the
morning. She agreed to
the blood test and was
most happy that the
Pom was walking on
four legs.
Yesterday, Dr Daniel
thought that a blood
test would add to the
cost as I had 4 X-rays
taken. "It should be
done since the owner
wanted to know why the
dog had been ill for
two weeks." I
explained.
SIGNIFICANT BLOOD TEST
RESULTS
Total white cell count
was 19.1 (6-17).
Neutrophils was 88%,
Absolute 17.00
indicating a bacterial
infection. The dog was
put on antibiotics.
Platelets were higher
at 720 (200-500).
VET 1'S MEDICAL
RECORDS.
Vet 1 had diagnosed
traumatic injury to
the back and advised
strict rest. But no
supporting evidence
was deemed necessary
in the two visits.
Each vet has his or
her own point of view
and so the diagnosis
of trauma was correct
and pain-killers of
NSAID of 3 types were
given. Meloxicam on
first visit. Then
tramadol and injection
of buprenorphine under
the neck skin.
"But there were 3
adult dogs inside the
caregiver's apartment
and they jump onto
this young Pom during
play time and
feeding," the owner
complained to me when
she visited on Oct 2,
2013. She was quite
upset as Vet 1 had
already given
instructions to let
this Pom rest.
"It will be much
difficult for me to
advise your
sister-in-law to
restrain their 3 dogs.
When your Pom is
crated, she will bark
furiously, causing
noise nuisance to
neighbours.
Is there any
possibility of you
taking back the dog to
your apartment and
crate her? Then there
will be no pouncing
upon her by the big
"heavy" dogs of your
sister-in-law. The
in-laws did phone me a
few times asking when
the dog will recover
as they had got some
backlash. "I don't
know when she will
recover," I said
frankly.
Surprisingly, in the
afternoon of Oct 2,
2013, the Pom could
walk and pace inside
the crate. She would
eat some of the A/D
canned food. When the
owner came with the
brown rice, she was
elated as the dog was
shrieking to go home.
"The dog has not
recovered yet," I
said. "It is the
drugs."
OCT 3, 2013
A bright sunny
morning. I videoed the
dog. She was reluctant
to move. At around 10
am, the owner came and
she was prancing and
shrieking. In the
afternoon, the
caregivers came. Too
much walking. At 7.22
pm, I checked on her.
She was reluctant to
stand, with her hind
legs underneath her
body and between the
front legs. However,
she could walk on 4
legs but there was
incoordination in the
back legs.
Expected to go home
tomorrow. If confined
properly for 2 weeks,
she should recover
from traumatic neck &
back injuries..
CONCLUSION
An unusual case of
quadraparesis starting
with back limb ataxia
for 2 weeks earlier.
Most likely there was
traumatic injury of
the neck and back
area. There was
intense pain in the
neck area on Oct 2,
2013 when I palpated
the neck to shoulder
area of the backbone.
This could lead to the
quadraparesis (unable
to stand on 4 legs
temporarily) but there
was Vet 1's record of
"pain on flexion of
the neck" before his
or her buprenophine SC
injection in the neck
area.
As to the cause of the
bacterial infection of
the blood, possibly
causing quadraparesis,
it is hard to locate
the source. One week
later, this dog passed
away without recovery
from the paraplegia.
No CT or MRI scans
were advised owing to
economic
considerations as such
scans cost from
$1,000/scan.
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No fractures or disc
problems seen in the 4
X-rays. C1 & C2 vertebrae
were not X-rayed. Severe
traumatic injury was
suspected. |
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Updates will be on this
webpage:
www.sinpets.com/F5/20131003quadrapareis
_Pomeranian.htm
 More
info at:
Dogs or
Cats
To make an appointment:
e-mail
judy@toapayohvets.com
tel: +65 9668-6469, 6254-3326 |
Toa
Payoh Vets
Clinical Research |
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