August 13, 2013
I phoned the owner to bring the dog down for abdominocentesis. He had consulted Dr Daniel who told me that the owner did not want the fluid drawn out from the abdomen, just medication. Dr Daniel informed me what he had said.
"It is best you record in writing what you advised," I told Dr Daniel. "The medication will not remove the excessive fluid which also involved the lower chin and neck (peripheral edema). There was no peripheral edema during the first consultation. The abdominocentesis must be done first or the dog will die from difficulty in breathing."
The owner said he was very busy with his work. I told him that there would be no medical costs to him. A chronic disease like ascites can be costly and need proper management, review and medication. This dog does not appear to have heart, liver or kidney problems but no X-rays or more tests could be done owing to financial constraints of the owner.
So I got the dog hospitalised. Dr Daniel put him under isoflurane gas and withdrew over 1,500 ml of abdominal exudate. The dog was feeling well and paced inside the cage. 12 hours later, his abdomen started to swell again. Abdominal neoplasia is suspected to be the cause of ascites. I sent the abdominal exudate to the lab for analysis of cancerous cells.