Tuesday, January 28, 2014

1319. Vomiting and more than 5-10X diarrhoea

Young Dachshund - vomiting and purging -10X despite emergency treatment at another practice.

Why?

Blood test agreed by owner shows that the liver is affected, platelets are low. However, total white cell count is normal.
Parvovirus test on faeces - negative.
"How about distemper?" the husband asked.
"Not likely to cause acute gastroenteritis."

Nowadays, young couples are much more sophisticated as the wife asked whether the dog had been infected with parvovirus. Treatment must be successful in acute gastroenteritis or the client loses confidence and goes to another vet.

As this dog went home purging non-stop, then the owner deems treatment unsuccessful. I did not board the dog. Neither did the first vet. 

FOLLOW UP

On 27.1.14
Diarhoea 2X, morning, afternoon and evening.
Vomited 2X at 6pm. Went to emergency treatment.
 After midnight, diarrhea 5-10X, wife keeps waking up to clean.

28.1.14
Admitted to Toa Payoh Vets
Treated and goes home at 8 pm
Only one diarrhea (a bit of watery stools) after midnight.

29.1.14 Phoned  to follow up.
9am - 12 noon. Active. Does not want to eat I/D canned. Drinks 50 ml of electrolyte + glucose from syringe. Water freely available. Crated.
No vomiting or diarrhea.  Advised 50 ml every 2 hours.

Diagnosis:
The dog had hepatitis and low platelet count. Owing to his habit of licking any human or object as well as being fed variety of new dog treats and canned food as well as being introduced to outdoor exercise as opposed to being in the HDB apartment for the last 10 months, the dog could have picked up or licked some toxic chemicals. The total white cell count was normal, therefore ruling out bacterial infection. Blood testing is the use of evidence-based medicine.

NB. The first vet prescribed "3 drontal tablets for cats". Vets must check the medication before dispensing as this may led to complaints. A lot of time must be spent on acute gastro-enteritis case follow ups. It may be too much to expect a vet to do so, but it is important.

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