Thursday, April 14, 2011

404. Follow-up on the itchy and scootering DachshundXJR

This is a follow up to a very interesting perplexing case I saw 2 days ago. My tentative diagnosis was allergy to the environment or dog food. The owner was more worried that the dog still scootered despite consulting Vet 1 earlier. Scootering was just continuous.

"My dog is calmer now. No more scootering and I don't scratch her anymore," the owner could not hear me distinctly as she was at the mall.

"What do you mean when you say you scratch the dog?" I asked the caregiver. "Well, I had to pet her and she would want more petting before I consulted you!". English is a hard language to understand. I was wondering why she would scratch her dog who was already itchy all over the body.

"How much hair loss?" I asked. She was not able to confirm as she was busy.

So far so good. I called to ask her to pick up the Hills' Canine d/d Potato and Salmon formula. It is a single animal protein source for allergic pets. The dog is not permitted to eat treats and any home-cooked or other food for the next 3 months. Then the owner can introduce treats and see if the body itch occur.

Painful ears with no infection, biting all four paws, whole body itch without skin diseases and hair falling out. These are one of the possible signs of dog food allergy. The dog just arrived from the USA. There could be multiple causes like heat, humidity, shampoos, stress and so many others.

We will have to wait and see. It is important that the dog does not scooter anymoe as that seems to be the main issue of the owner. She was very observant and said that I squeezed the anal sacs from quite deeply into the anal region. Of course, I did produce the grey particles and anal fluid. Evidence is important in veterinary medicine. The proof of the eating is in the pudding if there is such an English expression?



TODAY'S CASE
Old Jack Russell. Female, 8 years old said to be spayed 8 years ago and had no heat period.

Lost 2 kg from Oct 2010 (fat as a pig) to April 2011. Lethargy. Not eating much during past 3 weeks. Dried purulent eye discharge in both eyes suggested a serious systemic illness as in the hamster. Examine the whole body from mouth to private parts.

Dehydrated. Left gum ulcerated around Left Upper PM4. Yellow pus in swollen vagina (I showed to the busy lady owner's mother who brought the dog in). I suspected stump pyometra if the dog had not been properly sterilised but it could be UTI with pus inside the bladder and kidneys. No signs of vomiting. The dog just wanted to sleep and die.

BLOOD TEST. Low blood pressure and so I taught Min to use the tubing around the elbow and clamp with forceps just to collect 2 ml of blood successfully. Min is not inexperienced but he tended to do blood collection from the forelimbs and then the hind limbs but was unsuccessful today with both legs. So, I taught him how to fish rather than give him fish.

BLOOD TEST RESULTS

Very low platelets = 40 (normal 200-500). No platelet clumps. Large platelets present.
Liver enzymes elevated. Urea 15.6 (normal 4.2 - 6.3.
Red cell and haemoglobin below normal.
Total White Cell Count normal.

So what is the cause of the low platelets? I phoned the young lady. She said no Chinese medicine was given but the dog had the chicken flavouring or some powder added to the chicken meat for some weeks. Could this be the toxic substance depleting platelets? Would the dog live? Hard to say.

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