Saturday, November 20, 2010

The dog with white gums

In January 2010, I wrote an article on a case of Closed Pyometra in a female dog. The blood test shows anaemia and toxaemia in a female dog with pyometra. See the webpage at Pyometra - very low platelet count due to toxic blood.
URL is at:
http://www.bekindtopets.com/dogs/20100135Video_Education
_Closed_Pyometra_ToaPayohVets.htm


In November 2010, I had a very interesting case of a spayed female Miniature Schnauzer, 10 years old, losing 25% weight and not eating much for the last 3 months. When I saw the dog's gums, tongue and oral mucous membranes as white as snow, I predicted that this dog would not live past the next 7 days. I gave her intensive IV drip including glucose, saline, protein drip, multi-vitamins and Vit K1. An iron and Vit B complex injection SC was given. Baytril and metronidazole were given IV.



I took blood for analysis before and 24 hours after the IV and injections. The platelet count had dropped much further from 68 to 1. Yet 24 hours after the IV drip, the dog's gums and tongue were purplish pink in colour. I showed the colour to the lady owner. She was not impressed as she could not recall the snow-white colour 24 hours ago. I did not take a picture but I do remember telling her that the dog was very pale and anaemic.

She had been too stressed out by a bereavement in her family and now this dog was going to die.



Nov 11, 10 First consultation
Nov 12 24, 10 hours after IV
Ref Range
Unit
Total White Cells
12.8
6.6
6 - 17
x10>9/L
Total Red Cells
4
3.9
5.5 - 8.5
X10>12/L
Haemoglobin
9.7
9.6
12-18
g/dL
Platelets
68
1
200-500
x10>9/L
The dog survived and is well nursed by the lady owner as at Nov 21, 2010. As to the cause, I told her it was difficult to say. The cause would likely be a viral and bacterial cause. The dog had not been vaccinated since she was a puppy and was brought for walks in the past year whereas previously the dog was home most of the time.

BACKGROUND HISTORY OF THIS DOG RECORDED BY ME IN NOV 15, 2010
AT DEATH'S DOOR. THE DOG WITH WHITE GUMS
The thin, hunch-backed 10-year-old Miniature Schnauzer with white gums would not eat. She had been treated 4 times by Vet 1. ACTH tests were normal. Ultrasound indicated possible tumours of the liver, pancreas and spleen. So, the owner was very worried and wanted surgery.

"The dog is not fit for surgery," I advised. "She will just die on the operating table. Look at the white gums. She has severe anaemia. I will do a blood test."

The anaemia was due to low red cell count, low haemoglobin and very low platelet count. She was attended to by Vet 1 from August to November for 4 times and was not eating when the owner consulted me, being referred to by one of my clients.

Incredibly, after an intensive IV drip of saline, glucose, protein, Vit K1, antibiotics including baytril and metronidazole, B complex and iron injections s/c, the dog that lost 1 kg (25% of her weight in the last 4 weeks) was thriving. "She ate a lot and pooped a lot for the last 2 days," the young lady said. "Today, she is not eating. Shall I give her the Re... from Vet 1? It is said to improve her appetite."

What was the cause of this severe anaemia and the low platelet count? I suspect it was either some drugs or septic infection (from virus or bacteria) when the dog was brought downstairs in recent weeks.

During the first consultation with me, the dog screamed when I pressed the very painful disc pain at T/L area and bit me when I palpated the moderately enlarged left submandibular and popliteal lymph node. Her bladder was painful on palpation. Her left kidney was slightly painful. Her left tongue had some ulcers at the back and I took digital pictures to show the owner.

So what was happening to this dog? The lady had only one wish - that this dog would not die on her as she had a recent family bereavement. Yet, the dog's gums were as white as snow when I saw her at first. I did not take a picture then but her gums became a bit pinker 24 hours after the intensive care and injections. So, this dog had come back from death's door. But she is not out of the woods yet. Only time will tell.

UPDATE: No complaints from the young lady. I phoned her twice and the dog was getting better. Short episodes of panting which I attributed to pain in the spinal area. I asked her to give pred 2.5 mg two times per day. No more news from her. No news is good news, usually.

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