Wednesday, November 7, 2012

1170. Eosinophilia in a Chow Chow from tick bites?

Only the best for this client and his Chow Chow was his pride and joy. Last week, his man brought the dog to me. This Chow Chow had lost a lot of hair, around 80%, with some left in the head and tail. His bare skin was black. A bigger version of the hairless Chinese Crested dog. Lumps could be seen all over the bare skin. "Get your groomer to clip off all the hair," I advised. No news from him till 4 days later.

"The Chow Chow has lost appetite and is very itchy," the man in his 40s said. "He had lots of tck bites. We applied Revolution 2 weeks ago and Frontline 3 weeks ago."

The Chow Chow had two bleeding spots at the tips of both ears. I asked Dr Daniel to check for scabies mites by taking a skin scraping of the areas. "There is a tick seen under the microscope but no scabies," he aske me to view the slide. True enough. One newly hatched baby tick.

"It is best to do a complete blood test," I advised. "To check whether the liver and kidneys are affected as well as the overall blood cells."

"Let me phone Mr Tan first," he said. Permission was given.

CHOW CHOW, M, 3 years, 21.3kg, 39.3C

Blood test results
The following was low   Urea 4.0 (4.2-6.3); Creatinine 81 (89-177).

Total WCC was normal, but N 66%, L 12%, M 1.4%, Eosinophils 21%, B 0%
Absolute                                N 10.08, L  1.75,  M 0.21  Eosinophils 3.15    B 0.0
PCV and platelets normal

Could the tick infestations cause eosinophilia?
Yes. Parasites can cause eosinophilia. So can allergy and some infections.

This is one case where eosinophilia is caused by tick bite allergy.

On Nov 6, 2012, the next day after treatment of the dog, I phoned the man.
"The Chow Chow now eats his usual two meals a day," he said.
"Is he still scratching his body?" I asked. The anal sacs were also filled with thick greyish oil and could cause itchiness of the back and tail biting.
"A bit of itchiness, here and there," he was quite pleased with the response.

I was glad that this Chow Chow did not suffer from tick bite fever or anaemia. Surprisingly, the two Golden Retrievers living in the same area had not one tick. So, could the other dogs be immune to ticks or the Revolution and Frontline were working fine? It is a mystery.

PHONE CALL TO THE BUSY OWNER to understand what's going on.
Lately the entrepreneur is busy with interior designing business for new apartment owners.
"Did you propose a fish tank?" I asked.
"The units are so small nowadays," he said. "It is hard to place the usual cabinets, sofa sets and carpets."
He told me one expatriate sold off his 3-bedroom condo for S$2million and bought a villa with 6 bedrooms and a pool in Johor Bahru for S$1 million and has left over money.
Q1.  Was the Chow Chow's skin so black since young?
A.     No. Only since Mar 2012. The skin was pinkish.

Q2.  Your brother said that the two Golden Retrievers have no ticks at all.
A.   Not true. They have ticks and so have the other 7 dogs but this was not a big issue. The source was from the 19-year-old Cocker Spaniel who was allowed into the open field brought in the ticks. The other dogs were housed indoors as there is a big terrace for them.

Q3. Was there any ointment or medication applied to the Chow Chow's skin?
 A.  No. Coal tar shampoo was used for all dogs last year though.

Q4. When did the Chow Chow start losing hair?
A.   In March 2012. He started biting his tail and the hair loss from the tail spread to his back and then the body. His coat was so beautiful and he looked very big when he had a full coat.

Q5. Did you clear the ticks in the terrace?
A. A pest-control staff smoke-bombed the area once. It could be insufficient or the ticks hatched again. It ought to be done 2-3X e.g Monday, Tuesday and Friday like what is done for fish lice. Ont time is not enough. However, the Cocker Spaniel would bring in the ticks again.

Q6. Those skin lumps in the body. When did they occur?
A. These are due to tick bites. His skin would erupt in lumps whenever ticks bite him.

So, the clue was from Q6. This Chow Chow had urticarial lumps from tick bites. A tick bite allergy leading to an increase in the eosinophils since Mar 2012. It is always good to get the history direct from the owner if only the vet will take the trouble to phone this "busy" owner who loves dogs, kois and arrowanas. And rears only the best of them. Readers may chance upon one of my earlier articles and images of kois kept by him.

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