3364. Anaemia in a 14-year-old female spayed pug

Jun 26, 2019.
For the past 14 years, the pug did not have any physical examination or dental work. She has an enlarged nipple mass 8 cm x 5 cm.

Not eating. Blood work showed decreased red blood cells and haemoglobin for 3 blood work done on Jun 27, Jul 16 and 20, 2019.

X-rays - lung tumours and enlarged spleen.




Bleeding and iron-deficiency
Regenerative (check if there is an increase in reticulocytes) or non-regenerative anaemia?
Reticulocytes = 0.9% (normal) on Jul 20, 2019 

The pug used to have excellent appetite. 3 decayed teeth were extracted. The epulis (gum tumour) on the left upper canine tooth is unlikely to cause loss of appetite and anaemia.  

July 11, 2019. The owner complained that the pug was still not eating normally. She has inappetance and anorexia on certain days.  I advised the owner to put the dog inpatient for further IV treatment and get X-rays done. Dog came in on Jul 14, 2019.

2nd and 3rd blood work on Jul 16 and 20, 2019 showed low RBC and . Poor appetite. Needed syringe feeding to prevent weight loss.

1. decreased red blood cells and haemoglobin.
2. increase in total cell count and neutrophils suggesting a blood-borne bacterial infection.
3. increase in liver enzymes indicating liver disoreder - hepatitis or cancer.

4. Urine tests on Jul 19, showed urinary tract infection. Very smelly urine. 
5. X-rays (lung tumours, spleen enlarged), bone bone marrow biopsy (not done).
6. Blood babesia and E. canis - Nil
7. Faecal check for parasites.- Nil.

Tentative diagnosis: Lung tumours and severe anaemia
Poor prognosis.