Thursday, January 6, 2011

291. Jan 5 & 6 2010. Interesting cases

Case 1. Collapse, panting and high fever on Sunday Jan 2, 2010 like a dog having heat stroke.

Yesterday, Thursday, Jan 6, 2010, I phoned the owner of the 10-year-old Bull Terrier yesterday to enquire how was his fever. The dog was sent home yesterday after 4 days of intensive IV treatment and drugs. The owner took out his phone and played the video clip of his dog crying continuously for several minutes. "This is a cry of pain," I said. "Most dogs done whine like that unless they are in great pain." The owner said: "My dog was not active for the past 10 days, but I did not think he was sick."

Now, after 4 days of treatment, the dog could stand and walk a few seconds. His tongue colour was normal pink. I asked the owner to bring him home to nurse as I doubted that the dog would survive the next 7 days due to his poor blood test results. The dog's blood test showed septicaemia (high WBC to 39, low platelets to 6, increase in urea and creatinine and SGPT). 10 days before coming here, the dog had been boarded at a friend's laundry place.

The owner was to feed him AD diet and other food personally and gave him the drips SC and check his fever. "Spend time with him," I advised as there was not much time left, in my opinion. "Some owners do nurse the dog back to health when the dog is at home rather than being hospitalised," I said.

"He's the same but no fever," the man said when I phoned. "I force feed him the 4 cans of AD diet and eggs." That was good news as I expected the dog to be worse and to have fever returning.

As to the cause of the undulating fever, it could be bacterial or tick fever. There was no tick found on the dog and the owner did not know whether it had ticks in the friend's place. All he knew was that the dog went in healthy and came back sickly. In the 4 days at Toa Payoh Vets, his fever returned the next day and receded when given tolfedine anti-fever. I treated him with different antibiotics for bacterial infections and tick fever before sending the dog home as a dog with no fever.

Will wait and see. Blood test showed that he had a bad bacterial infection and toxic blood due to extremely low platelet. Without intensive IV drips, he would be dead within 24 hours. It was a miracle he was alive at all.

Case 2. A Cocker Spaniel came in with 3 days of purging. "We saw blood in her stools," the couple in their late 30s had boarded the dog at Pasir Ris boarding kennels. The dog had its yearly vaccination. "Why diarrhoea?" the owner asked. "The kennel operator had told me and had asked me if I wanted to send the dog to a vet."

"It is hard to know the cause," I said as the owner declined blood tests to save cost. "There are many reasons. The vaccination protects against the serious viral and bacterial infections." The dog was eating. I hospitalised it and treated it with IV drips, antibiotics and anti-diarrhoea IV. Should be OK after 2 days as the intestines get to recover without food intake irritating their surfaces.

Case 3. A thin 1-year-old female Shih Tzu kept vomiting for the past 10 days. Yesterday, the owner agreed to blood tests and X-rays. X-ray showed small white globular object inside the stomach. Another opaque one in the bladder. Could this be the cause? This is an extremely high risk anaesthetic case as the dog was very thin. So I did not dare to operate as the death was almost guaranteed. Yet, the dog continued vomiting daily. She vomited blood. I thought it was pyometra as there were vulval discharge. Was it kidney disorder? Will wait for the blood test as the owner agreed finally to the blood test.

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