Thursday, February 13, 2014

1329. Audit of case: 14-year-old Maltese lost appetite and cannot stand up

TP XX988
Maltese, female, not spayed, born Feb 20, 2000

An elderly couple takes care of this dog as the daughter has married and left her dog to parents.
On Feb 12, 2014, the dog had eaten very little for the past 6 days. Yesterday, heavy breathing, limping and was unable to stand up on hind legs. Could walk but slowly. Had "fits" lasting few seconds. What's the problem?

"When was the last menses bleeding?" I asked as the dog was not spayed and I detected some mammary gland swelling and dirty black brown nipple discharge which I showed the couple. .
"No more bleeding for a long time," the wife said.
"Is there a period of time when the dog was continuously cleaning her private parts?"
"She cleans herself after urination," the wife said.
"Any cleaning even though there was no peeing? For example, 2 months ago, before Christmas?"
"Yes, sometime in December. She was busy cleaning herself."
"14-year-old dogs still can cycle," I palpated the lower abdomen and the spinal area. The uterus was swollen at around 1 cm in diameter and the T/L spinal region was painful on palpation.
"Your dog has pyometra and false pregnancy," I said. "A hormonal imbalance. If she had been spayed at a young age, there will be no problem."

Blood test showed an elevated AST/SGOT of 106 (normal <81 89.4="" at="" but="" cell="" count="" glucose="" high="" neutrophils="" normal.="" normal="" p="" the="" total="" was="" white="">
"This is the start of pyometra," I said. "The dog is aged too but the blood test is normal except for increase in neutrophils.Did the dog vomit?"
"No," the wife said. "She vomited once and was not eating for 2 days in Feb 6, and Dr Daniel had a blood test done."
The blood test was normal except for glucose at 9.4 (3.9-6.0) and Neutrophils at 86.4% similar to the recent one.
The owners did not want an X-ray.

It was lucky that I could show the nipple discharge of false pregnncy. "The hormonal imbalance can cause the dog to lose appetite as in this case. The dog would eat a bit of the canned A/D diet and nothing else. I advise spaying to remove the abnormal ovaries but the anaesthetic risks are very high as the dog is 134 years old now."

The couple would let the daughter decide. Strangely, without eating much, the Maltese came in for the 3rd injection (today) was much alert and walking with unsteady gait. Her rectal temp was normal at 38.3. The husband remarked that she was much stronger now. Dental scaling by Dr Daniel yesterday appeared to be good for the dog as she permitted me to open her mouth unlike previous days.

Today I would give the antibiotic and S/C amino acids. The problem is that the owner cannot syringe feed he dog with antibiotics and canned food as the daughter lived far away. Without hand or forced feeding and electrolytes, this dog will soon get emaciated.

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