Saturday, April 20, 2013

1381. TRUST & AUDIT CASE: Trapped bladder in perineal hernia in a Pom

Sunday Apr 21, 2013

Pom M, Not Neutered, 6 years, 9.7 kg. Perineal hernia, right present for 2-3 months. His father had perineal hernia on the right, the owner told me. Dog was operated by Dr Daniel on Apr 16 and went home on Apr 18, 2013 as I advised that he would be better cared for and eating home food. He had vomited post-op, once on the next day after surgery

I have written many case studies of perineal hernias in male dogs. This report will deal with the findings of a blood test as evidence of a Pom with a long-standing perineal hernia (purplish skin and as hard as an orange).

April 16, 2013

I first saw this dog. Bruised purplish hard swelling 8c m x 8 cm x 5 cm, right. Can't poop for 2 days. Can pee. Anorexic, not neutered. T=36.5 deg C which showed a danger of dying as temp is below normal. Dr Daniel decided on same day surgery with IV drip stabilisation before surgery.

Blood test showed:

Azotemic   Urea, creatinine increase,  WCC increase, ALT increase

SGPT/ALT  151 (<59 p="">Urea  67 (4-6)
Creatinine  1052 (89-177)
Total WCC  20 (6-17)
N= 76%, L=5%, M=18%, E=0.1%, B=1.3%


The interesting findings are:
1. M=18%. Normal values should be 3-10%.  This indicated a chronic inflammation. The hernia existed for 2-3 months and the trapped bladder and intestines must have caused a chronic inflammation. The skin of the hernia turned cyanotic and this showed cell death. Gangrene black colour would occur soon.

2. Azotemia. Bladder was trapped inside leading to obstructive flow of urine and so increase in urea and creatinine.

FOLLOW UP
The dog managed to stand on Day 3 but for short while. Sent back home by me yesterday as he would be better cared for at home. The biggest Pom at 9.7 kg although he was born as a runt, the owner told me.


Today Sunday 11.30 am, I phoned to follow up by phone.

"He has just passed away," the owner said. "At 5 am, he barked his usual time.




  










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