Tuesday July 10, 2012, I had a discussion with Video producer Nicole, Dr Daniel, Dr Vanessa and Intern Siti, a 4th year student from Serdang Vet about the diagnosis and treatment of tick fever in dogs, using a real case example referred to me recently but died within 4 hours of arrival. Siti is to present this case in her 5th year and so she was writing up the case. I gave her a day to write the case but she could not do it.
What is tick fever?
What body systems are affected?
When do clinical signs appear from the start of infection?
What should be done to diagnose tick fever is suspected?
The vet had 3 differential diagnosis - pyometra, tick fever and liver failure. His medication indicated that he was treating for liver failure and had given the owner a poor prognosis.
What is most important question to ask in the history if tick fever is to be diagnosed?
What laboratory tests must be done?
What signficant aspects of the tests must the vet look for?
What is the cause of death in this Samoyed?
An autopsy would be needed but the owner would not want it.
1. Kidney failure according to one senior vet, based on the 2nd blood test.
AMA - Against medical advice. The vet did record in his case file that the owner did not want a tick-vector test to be done. The vet has given his advice but it is up to the owner to accept his advice as the owner pays for the test.
Follow-up. The vet recorded that he did phone the owner 3 days after treatment. That is good practice, but the owner denied having received any call.
Medical negligence - The burden of proof is on the owner. Was this vet negligent? My answer is no.