Thursday, October 15, 2015

2330. Closed pyometra. Why my dog not eating 7 days has a swollen abdomen?

Oct 15, 2015

A new case.
"Why my dog has a big abdomen although she has not eaten for one week?" the lady in her late 40s asked me on this bright blue-sky white cloud morning as the haze from the Indonesian forest fires seemed to have disappeared today. The sun was bright and glaring unlike the past days when it was orange.


This was a female, 9-year-old Cavalier King Charles that had never been to the vet for many years as she was never sick. Her teeth were decayed and there was  a large gum ulcer (video) on the left upper canine tooth area.





If the dog was anorexic for one week, her stomach should be tucked in and not bloated out. So, what was happening?

"Has the dog been spayed?" I asked the lady who would be leaving for China tonight.
"No,"
"Was her last estrus heat within 4 -8 weeks ago?" I asked.
"4 weeks ago."

The dog could barely stand up. She had pale gums. I palpated the lower abdomen as the owner steadied the dog in the standing position. The dog winced in discomfort on palpating the lower 1/3 part of the abdomen.

"I am sure this is a closed pyometra at 99%," I confirmed that the dog had vomited during the past 3 days, indicating renal failure.

Blood test showed
Total white cell count  67.8 (6-17)
N = 95.4%  (60-70), Absolute 65  (3-12)

Red cell count = 3.5  (5.5-8.5)
Hb  = 7.7  (12-18)
Platelets less than 10
urea  41.1 (4.2 - 6.3)
creatinine  339 (89-177). There was septicaemia and renal failure leading to vomiting.

I was surprised that the dog is still alive as she is septicaemic in her blood.
Full of bacteria and toxins. The dog could not stand up but still wagged her short tail as the owner said goodbye, leaving her at Toa Payoh Vets for surgery. The risks were extremely high but there could not be a delay in surgery as the uterine horns may rupture.

x-rays showed swollen uterus.






TREATMENT - SURGERY - EMERGENCY SPAY















Emergency spay done by Dr Daniel after IV drip 2 bottles on the same day. I had given IV antibiotic and antispasmogesic. The dog's heart failed during surgery but was revived with Dopram.






FOLLOW UP
Oct 16,2015  10.30 am.
I phoned the home as the owner was in China. The dog drank but did not eat. I advised the maid to spoon feed one can of A/D slowly and let me now.

If only the owner had spayed the dog, there would be no worries about closed pyometra. The dog does eat cockroaches but the abdominal swelling was due to large swollen uterus.

Within the next 7 days, we will know if the dog can survive.

Oct 17, 2015 1.15 pm
The dog has started eating, according to the Myanmar maid. The owner is in  China. So it is good news. The maid had given the antibiotics and painkillers. But not all every pyometra case ends with such a successful outcome at Toa Payoh Vets or at any vet surgery.  Delays in seeking vet treatment resulting in serious kidney failure and septicaemia are the reasons for vomiting after surgery or death on the operating table. .  

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