History: On Jul 6, 2010, 9pm. Lethargy, not eating
for 2 days. Fever and white gums and tongue. The
domestic worker said that the dog was given
(chicken +/or fish) bones by a family member
recently.
Presenting signs
Acute abdomen (anterior). The dog turned and
nearly bit me when I palpated the anterior
abdomen.
Blood test on Jul
7, 2010 - toxaemia and anaemia. The
following significant results were:
Low red cell count ( 4.1) and haemoglobin (10.4)
Low packed cell volume (0.3) Low platelets (47). No platelet clumps seen
but few giant platelets present. Surprisingly, the
White Cell Count on admission was below normal at
5.4 with neutrophils 94% and lymphocytes 4%
instead of a big increase.
The liver profile was normal. Kidney profile -
urea was normal. Creatinine was below normal.
Blood Heartworm test: negative
Urine test on Jul
8, 2010. Full bladder was catheterised to
collect brownish red urine. X-rays showed
one urinary stone. Results were as follows:
Urine was
brown and turbid. SG 1.020 pH 7.0. Abnormal findings
are as follows:
Protein 3+, urobilinogen 1+, bilirubin 3+, blood
4+, White Cell Count 58, RBC 243, Crystals of
amorphous phosphate 2+, triple phosphate
occasional, bacteria 3+
X-rays on Jul 8,
2010.
Stomach was filled with radio-opaque granules.
Some larger radio-opaque lumps are present in the
intestines. These were likely bones and other
foreign bodies. The spleen was moderately
enlarged.
Diagnosis
Toxaemia. Impacted stomach and intestines and
urinary tract infections.
Treatment on Jul 7 & 8, 2010
IV drip x 2 bottles (glucose saline + saline) x
500 ml each for 24 hours
Vit K1 2ml in drip.
Baytril 1.0 ml, Tolfedine 4% 1.0 ml x 2 days in
IV.
No fever on Jul 8, 2010. Dog more alert but does
not want to walk or poop.
Stomach mucosa bleeding? The dog went home for the next 2 days
for observation of pooping. A laxative liquid was
given. The owner had been informed about
poor prognosis if the dog does not poop or has
more stomach bleeding
In this case, the blood results, especially the
low platelet count were important and
indicated that the dog was a very high anaesthetic
risk.
I stabilised the dog using IV saline (5% glucose
saline 500ml, then saline 500 ml), Vit K1 (2 ml,
slow IV), baytril and tolfedine IV. 24 hours
later, the owner's son and domestic worker came to
visit. The dog's tongue was pinkish and he looked
much more alert.
Goes Home On Day 3
The dog was eating a bit of the canned food (A/D
diet). I observed that he had rapid
respiratory movement when crated. He went
home on Day 3. What was the cause of his
toxaemia and fever? Poisons inside the stomach? Tick fever?
Urinary tract infection?
It was hard to know as the owner disputed the
domestic worker that the dog ate bones.
I sent the dog home with a laxative and
antibiotics and instructions to call me in 2 days
if the dog was not all right. 5 days after
consulting me, the dog was all right as the owner
e-mailed me as follows:
OUTCOME
E-MAIL TO DR SING Sun, Jul 11, 2010
Dr
Sing,
Thanks. My dog is much better now - it
eats well and passes urine and motion
daily.
Do we continue giving it all the
prescribed medicines? When do I bring it
back for you to check?
As
to what was the exact cause of the
toxaemia, this is hard to say.
There are many causes and
supporting IV drips and drugs
returned this dog to normal so
far. For more interesting canine
cases, go to:
Dogs
TOA
PAYOH VETS
