Tuesday, September 4, 2012

1080. Retrospective study: Vaginal hyperplasia & Prolapse Type II in an old female chihuahua

"Very tired, not moving," the home-breeder said. "Not eating  1's for the past 9 days and vomit when given canned food." There was a red"tongue-like" tissue hanging from the backside of this 10-year-old female Chihuahua, fawn/white.

On Nov 18, 2011, he had consulted Vet 1 who noted "vaginal/uterine" prolapse and advised spay. She informed him there could be pyometra. She recorded that he declined blood testing. He did not want surgery as the vet warned of high anaesthetic risk. So he took some medication. However, his dog did not eat again. Four days had passed. Vet 1's Nov 19 blood test records showed elevated liver enzymes and marginal elevation of WBC (Total WCC 17.2). Her ultrasound showed mainly liver, gall bladder and kidney issues. Urine tests showed presence of glucose (3+), blood (4+), bacteria (2+), epithelial cells, WBC and RBC. However, in retrospective review today, of the differential count, neutrophils was 88% (high) and platelets 181 (200-500) was low.

The owner wanted non-surgical treatment. But there was none. Surgery was the option but highly risky as the dog had been sick for some days.

He wanted me to do the surgery which was done on Nov 27. I got a blood test done on Nov 25. This time the Total WCC was 33.2 (6-17), Neutrophils was 96%, platelets 14 (200-500).  NOW, the haemoglobin 5.3 (12-18) and red cell count 2.7 (5.5 - 8.5), Haematocrit 0.15 (0.37-0.55), MCV 55 (60-77) indicated severe anaemia too. Platelets are 14 - clotting problems exist now - dog unable to clot when the tissues are cut (see image of my report case).

1. Spaying the dog when she was young would not have caused this serious health problem.
2. Often the owner is not aware of the seriousness of the problems as the vet mentioned "high risk" and death likely.
3. The vet was not able to communicate the need for prompt surgery (1-2 days on Nov 19 , not wait longer) as delays would make survival very low.

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