Saturday, May 21, 2011

449. Show, don't tell - Maltese shivers and has bloated "stomach"

On Saturday, May 21, 2011, I returned to the Surgery to discharge the shivering Maltese that had been hospitalised and treated for the past 2 days and is now OK. An earlier report is at:  The Maltese dog with a bloated abdomen keeps shivering. Why?
 

"Did the dog pass stools?" I asked my assistant Min. "No," he said. I expected this answer as I had given the dog an anti-spasmodic injection on day 1.

The dog had not I palpated the abdomen. It was not bloated but felt full and rounded. The concerned lady owner would be flying back from Hongkong today. Her mum and her brother came to get the dog home and to be briefed on what's the problem.

SHOW, DON'T TELL

1. INTERPRET THE X-RAY TO THE OWNER
X-ray of distended bladder had been shown to the mum and e-mailed to the owner in Hong Kong with explanation of a urinary tract infection. The owner was far away and was worried.


2. DEMONSTRATE THE BACK PAIN.
"Since the dog was boarded with a family that has small children, it is possible that the dog had been injured on her back," I told the mother and son. I put the dog on the table and pressed the length of the spinal area from the neck to the tail. "Can you hear the 'cough sound' when I pressed this area (thoraco-lumbar)?" I asked. "That is the area of pain. Something could have been dropped onto her back but I cannot say this is the case. The dog could have fallen on her back. The pain would cause the shivering."

They did not hear anything. I repeated three times and reproduced that very soft sound reaction in that area. The son lowered his head nearer to the dog standing on the table. I repeated the procedure. He heard the sound.

3. DEMONSTRATE NO BACK PAIN IN A NORMAL DOG
I got a normal Shih Tzu and repeated the spinal area pressing. Not a single sound came from this dog. "A normal dog will not 'cough' in reaction to my pressing of the spinal area as he has no pain there," I convinced the mother and son.

The dog went home. She had a nasty neck skin infection (yellow flakes on red skin, right eyelid infection and both elbow skin inflamed). "My daughter had seen many vets - yeast infection but no cure after many visits to the vets. She researched the internet and does her own treatment," the mum said. The rest of the coat was thick and normal. A small amount of dandruff fell off the dog's body. I said: "The neck skin infection should be cured as the dog keeps scratching. I will say that the neck skin should be normal if treated properly." Unfortunately, some owners give up when their vet or vets failed to produce results for the skin infections and do self-treatment instead.

4. SHOW THE URINE RESULTS. Dipstick indicated bacterial infection of the urinary tract infection. The change of colour was shown to the mother earlier. Laboratory results are not in yet. Blood test report with no abnormal findings were given on discharge of the dog.





In conclusion, this dog's shivering could be due to more than one cause. The pain in the spinal area, the pain in the neck skin area and the pain in peeing from an infected bladder. If only dogs can talk.


PICTURES AND UPDATES ARE AT:

http://www.sinpets.com/F5/201006237shivering-bloated-abdomen-female-maltese-ToaPayohVets.htm

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