Saturday, February 15, 2014

Sunday's interesting case - A papillon with fits from Tampines is active now


Sunday Feb 16, 2014

"Do you remember my old dog with fits for 2 days and kidney failure?" the woman in her late 30s walked in and told me the name of her dog. "A small black and white dog" she held both hands apart to indicate the size of the Papillon.

"I can't remember as there are many old dogs with kidney failure and fits," I took out the medical records while the lady had her own 2 receipts. The dog had 12 rotten teeth extracted on Jan 12, 2014 by me. Blood test had indicated kidney failure with high counts of urea at 64 and creatinine 260. Neutrophil % was high at 86% but total white cell count was normal. Blood calcium was low but glucose was normal.

"Cha Cha has good appetite and is very active," she said. "Luckily I didn't put her to sleep!"
She syringed 50 ml water 2x/day daily and fed k/d canned food with rice and minced chicken. The dog just ate all.

I did not expect to hear from owners. After all this dog was aged at 13 years old. But he is as active as can be.

"I think the fits are due to his rotten teeth," the lady said. I agreed as there were no more fits since dental extraction. No more lethargy and staggering. A positive outcome and no euthanasia as advised by her friends justifying that the dog was old and had fits.

I advised k/d for 3 months and take a blood test. It is difficult to advise based on recovery. This was a case referred by her friend to me and only positive outcomes can generate referrals in medicine and surgery. Fortunately the dog did not die under general anaesthesia (using isoflurane gas only). Otherwise, no happy ending from the lady in Tampines as the vet gets the blame when death on the operating table occurs.

Yearly dental check up will be best for dogs over 5 years but Singaporeans are too busy to do it. So, many aged dogs have foul breath and loose teeth. Painful mouth ulcers and tooth ache can lead to fits. This was a surprisingly good outcome case as I thought old dogs with fits will not live long. But here he is. Good appetite and active.

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