Wednesday, March 18, 2015

1141. Two cases. 1. Pyometra - vomit and "bloody" diarrhoea. 2. Hyperestrogenism - Swollen vulval area

A young lady's 10-year-old Cocker Spaniel had vomiting and bloody diarrhoea for around one week.
"There is a smell of blood," I said. "The blood test showed low red cell count and haemoglobin. The white cells increased showing bacterial infection. The platelets are low, showing septicaermia. The signs are not good."

I advised inpatient for 2 days with IV drips. Tests for Giardia, coronavirus and parvovirus were negative.

The lady wanted her dog back on the same day. At home, the dog continued vomiting and passing bloody stools. "She is having her heat period now," she said. The next day, the dog passed away at home when I called.

This could be a case of closed pyometra with "heat" being observed by the lady on the day before the dog died.

The dog reacted wanting to bite me when I palpated her lower abdomen. She was overweight and so I could not feel the distended uterus. Septicaemia would result in vomiting and diarrhoea. However, the lady did not want the dog to be warded and this is the owner's wish.

This death could be prevented if the dog had been spayed at a young age. But many owners prefer not to spay their female dogs. The illness and death stressed this young lady considerably. It affected me too as I would like all pyometra dogs to live.

However, I could not operate as this dog was unfit for surgery. Blood transfusion would be costly and there was some financial concerns in this case.  Prevention by spaying the dog would have been much cheaper but many owners do not expect their female dogs to suffer from pyometra.

Mar 19, 2015.
Another case of suspected pyometra today. The 4-year-old Shih Tzu licked her vulval area till it became 10X larger than normal (video). Some female dogs are very clean and would lick off every small drop of vaginal discharge till the vulval area became much swollen, as in this dog. Another possibility is hyper-estrogenism.

The owner confirmed that this dog was very clean. She had fuzzy memory of the onset of the last heat. "Maybe November," she said.
"When was the earlier heat?" I asked.
"May," she said.
"So it is March now," I replied. "However, not all dogs come on heat exactly 6 monthly."

Antibiotics now. Spaying 2 months later is advised.

2 abnormal results
Blood glucose  12.1  (3.9-6.0)
Monocytes 18.3% (3-10),  Absolute  1.94 (0.15 - 1.35)

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