Friday, January 24, 2014

Follow up: A shivering Schnauzer

Jan 24, 2014 Follow up on yesterday's treatment

Yesterday, the "7-year-old Schnauzer" came in shivering. Vomiting and diarrhoea for 1 week.
Attended to by my associate vet who took a blood test. High total white cell count 20 v. 6-17 and neutrophils  95% v. 60-70%,, creatinine (447 vs 89-177) and urea 37 (4.2-6.3).  RBC 4.4 v. .5.5-8.5, Hb 10.7 v. 12-18.

I got the dog X-rayed.
I palpated the abdomen. No swollen uterus and no pain on the X-ray table after X-ray. X-rays did not reveal swollen uterus but gas in the intestines.

The owner did not want the dog warded for drip. One IV drip of Hartmann was given. However, when I spoke to the owner, she said the vet did not advise hospitalisation.  Medical advices should be in writing on the case record, I always advised young vets but this was not done.

Diagnosis was kidney failure and bacterial infections. Anaemia was present. The dog needed to be warded for treatment but this is advised and it is up to the owner to comply. The owner will bring the dog to Surgery today.

Much time is needed to follow up. The dog was adopted for 7 years at 3 years of age and should be 10 years old now!
"How about the heat period? When was the last bleeding?" I asked.
"Do you mean her menstruation? " the young lady owner did not know and asked her mum. "Last May or June. However, her menses come around 9 - 12 months' interval."  
"This is not normal," I said. "Most dogs cycle around 6 monthly."

It is possible that this old dog actually suffers from pyometra. Bacteria goes to the kidneys and blood causing vomiting and diarrhoea. Blood test shows kidney failure. The primary cause may be a womb infection. If the owner has spayed the dog young, this pyometra would not have occurred. Abdominal palpation may not reveal closed pyometra. I did feel swollen tubes around 5 mm in diameter on the lowe 1/3 abdomen. Only surgery will confirm but this dog is not fit for surgery now.

This is the type of case where any medical advices regarding hospitalisation ought to be recorded in the medical records to avoid misunderstanding.  


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