INTERN An unusual case. A 5-month-old Yorkshire Terrier has "kennel cough" for over 2 months

Sep 14  2017

HOOK



The owner showed a video clip of her puppy coughing and coughing 2 months ago.




Coughing like an old man with lung disease after purchase from a pet shop in Singapore. Hacking cough. Dry cough. Nothing coughed up.
 

Uncomplicated cases recover around 14 days. Complicated case in this Yorkshire Terrier - seen Vet 1 two times and given antibiotics and anti-histamine in the past 2 months. Still coughing daily when seen at Toa Payoh Vets in Sep 13, 2017.

What cause this Yorkshire Terrier puppy to cough and be itchy for over 2 months?

This video discusses an uncommon case of a puppy suffering from dry coughing for more than 2 months.  
KENNEL COUGH RESPIRATORY DISEASE and SKIN DISEASE.


PART 1. KENNEL COUGH RESPIRATORY DISEASE.


PART 2. SKIN DISEASE
This sister referred this her sister to Toa Payoh Vets to get the itchy skin disease treated.








CONCLUSION

Many new puppy owners are not aware of the need to do a post-purchase veterinary examination of their puppies. Some reputable puppy sellers in Singapore do advise a 24-hour veterinary examination after purchase of the puppy to check its health.

This Yorkshire Terrier puppy was purchased at 3 months of age. She was coughing and had been scratching her whole body since purchase. The owner had consulted Vet 1 twice to cure her coughing. Vet 1 took X-rays and said there was no pneumonia. Anitbiotics and anti-histamines were prescribed, but the cough persisted for over 2 months. The owner  
.

X RAYS by Vet 1
Cloudy areas around the lungs and heart indicate inflammation and fluid accumulation. This is known as pleural effusion. The inflamed lungs not as black as in normal lungs.

Auscultation at Toa Payoh Vets. No acute pneumonia. The following tests were done to assess the health of the puppy. 

1. BLOOD TEST
Leucocytosis with neutropenia and monocytosis.



IMAGE OF BLOOD TEST HAEMATOLOGY
There was an increase in total white cell count 2 months after purchase. (SHOW BLOOD VALUES).  So the dog had an infection for a long time.

2. INFECTIOUS DISEASE TESTING
2.1 DISTEMPER ANTIGEN TEST KIT
Distemper causes coughing. Test Kit. Negative.

2.2  PARVOVIRUS AND CORONAVIRUS TEST KIT. Negative.

CONCLUSIONS.
The puppy was not vaccinated against kennel cough. Other viruses like canine distemper, parvovirus and coronavirus could have had infected the puppy but did not cause disease. This is evident from negative test kits to the above-mentioned viruses. (VIDEO FOOTAGE).



 ADVICES
KENNEL COUGH VACCINATION SCHEDULE
SC or IM. Inactivated vaccine. Pneumodog.
Intra-nasal. Live modified vaccine. Broncho-Shield III


PUPPIES
2 vaccinations for puppies

1.  Puppies born from vaccinated bitches
First dose at 6th week
2.  Puppies born from non-vaccinated bitches
First dose from 4th week
Booster vaccination 2-3 weeks and yearly after the lst vaccination

ADULT DOGS for boarding. 7 days before boarding prevents respiratory infection. Some owners had complained that their dogs cough after boarding. Well managed boarding kennels in Singapore require current vaccination to avoid such complaints.

PART 2
Itchy skin  seen purchase 2 months ago. Why?
Ringworm and bacterial infections were present as evident by round skin lesions and bacterial pustules on the body. .

UVL - flourescence +ve
In-tray test. 7 days needed to confirm.

Enforced cage rest
Antibiotics
Good quality food







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2 types of vaccines are available at Toa Payoh Vets.  Pneumodog is an inactivated vaccine that is given under the skin or into the muscle, but no dropped into the nostril unlike Broncho-Shield III..

Broncho-Shield III
is a modified live virus vaccine
Nasal only. Not for injection SC or IM
lst vaccine from the 8th week. Repeat 2-3 weeks later. Annual booster.
7 days before boarding for adult dogs

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Diseases can be fatal to older dogs.
Dogs are family members.
PREVENT DISEASE BY VACCINATION.  Your dog lives to a ripe old age.

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Oct 2, 2017  Review Bailey. Still coughing
but less. 

3136. A long-standing corneal ulceration and pigmentation in a dog

Owner did not seek veterinary treatment for many weeks. Looks like a descemetocoele from close up images.

3135. INTERN, EOSINOPHILIC GRANULOMA COMPLEX. A very old cat has eosinophilic granuloma complex ? Evidence needed.

Sep 12, 2017. At Toa Payoh Vets, big bleeding granuloma now seen.

Thin. Gums are cyanotic and possibly anaemic. No mouth or gum ulcerations.
Only a large granuloma, 1.5 cm x 2 cm x 1.0 cm below the chin.
No heart disease. No blood test, so not possible to assess liver and kidney functions.

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Owner had handphone pictures. Asked to be sent to me.

Need dental scaling. Cat has periodontal disease.
No blood test to screen health. Heart and lung and abdomen OK. .

biopsy of granuloma - advised
Fine Needle Aspiration. Impression smear of granuloma - advised. See lots of eosinophils in the smear or biopsy
Check for FIV/Feline Leukaemia needed.

Megestrol acetate given instead of corticosteroid in this case. 5 mg/day for 7 days and then alternate days. Cat's granuloma no longer bleeds so much, according to the owner when phoned 8 days after treatment. See images.

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WHAT IS EGC?  3 presentations






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OTHER SUSPECTED CASES OF EGC BELOW:

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Diagnosis

DIAGNOSIS is best confirmed by a biopsy or fine needle aspirate of the eosinophilic plaque but the owner wanted to save money and permitted FIV and blood tests only as she has other stray cats to pay for expenses. In this case, the blood test show a higher % of eosinophils at 6% and the clinical signs of oral ulcers, plaques and an old leg wound now healed) indicated a likelihood of the EGC.
Blood Test Results - significant findings
1. Glucose elevated 11.0 (normal 3.9 - 6.0) - "stressed induced hyperglycaemia" in the cat.
2. Liver enzymes ALT & AST elevated --- clindamycin >15-20 days and other antibiotics and powders could affect the liver.
3. Urea below normal.
4. Platelets low 146 (300-800). Large platelets present --- toxic products from medications affecting the platelets?  

RBC and WBC are normal.
Differential count - % and absolute numbers are:
N 64%   8.69
L 24%   3.19
M 6%    0.77
E 6%     0.81
B 0.3%  0.04
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3. RODENT ULCERS IN CATS (feline eosinophilic granulomatosis). Salivation and ulcers are signs.

Eosinophilic Granuloma Complex (EGC)
Three distinct but related clinical syndromes comprise the granuloma complex:

3.1 Eosinophilic (or rodent) Ulcer. This may occur on the skin or in the mouth but usually affects the upper lips. The lesions are well-demarcated ulcers.

3.2 Eosinophilic Plaque. These are raised, moist, red eroded or ulcerated areas with a well demarcated border. Pruritus is usually severe. Lesions usually occur on the underside of the cat (abdomen, brisket or inside the thighs).

3.3 Linear Granulomata. These can occur at most sites, especially behind the hind legs and within the mouth. They are well-demarcated lesions which are raised and yellow to
yellowish-pink in colour. They are often thin, hence the name *linear* granuloma.

Treatment:
1. Allergy to fleas, mites, parasites, environmental,
Steroid, ivomectin inj.

2. Allergy to dry cat food.
    If food allergy, hypo-allergenic canned food 6 weeks