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- This 8 week old white German Shepherd puppy was adopted 2 weeks ago from the breeder by the current owner as the breeder was going to euthanize the dog (it’s the runt). The breeder stated that the puppy became ill after receiving its first vaccine. It is unclear if the vaccine was administered by the breeder or a vet. Pyrantel deworming was also performed prior to adoption.
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- This 8 week old white German Shepherd puppy was adopted 2 weeks ago from the breeder by the current owner as the breeder was going to euthanize the dog (it’s the runt). The breeder stated that the puppy became ill after receiving its first vaccine. It is unclear if the vaccine was administered by the breeder or a vet. Pyrantel deworming was also performed prior to adoption.
- The puppy presented to the 1st vet clinic on 9-28-16 for neurological signs and decreased appetite. Bloodwork done at that time showed HCT=14.8, MCV=44.7, MCHC=34.5, MCH=15.4, 1.2% reticulocyte count, Glu=62, BUN=21, ALB=1.9, P=3.8, Ca=7.8, ALT<10, Lipase=5765, and Creat=0.2. The vet treated with iron supplementation and mirtazapine.
- The puppy presented to a 2nd clinic on 10-7-16 for inability to stand up, right itself, or eat on its own. Because of the neurological signs, shunt was put on the rule out list and an ultrasound done today. The puppy will eat when syringe fed and has slight improvement in its neurological signs. It still only weighs 3 lbs.
- I don’t see any extrahepatic or intrahepatic shunts. I can see what I think is normal branching of the portal vein just caudal to the liver (see pic). The liver appears normal in size. There are no bladder or kidney stones and the kidneys appear normal in size.
- The stomach is fluid distended with thickening of the gastric wall and poor wall detail. The small intestine shows small amounts of mild anechoic fluid distension again with poor wall detail. No FB’s are seen. The puppy’s mucous membranes are very pale so I suspect the anemia is not resolved and may have progressed.
- Is it normal to see poor GI wall detail in an 8 week old puppy? I suspect the gastric stasis is due to generalized illness. My differentials for the previously noted neurological signs include profound weakness from the severe anemia, vascular accident, infection-meningitis, hypoglycemia, and liver disease. Differential diagnoses for the severe anemia include parasites (none found), blood loss (GI?), autoimmune disease (vaccine reaction), and bone marrow disease. I have recommended a CBC to reassess the anemia and determine if it is regenerative or not. I suppose bile acids can still be done. A fecal has been sent out. Any other thoughts?
Comments
What a mess.
I would be
What a mess.
I would be concerned about parasites- especially hookworms. The anemia does not look regenreative on your bloodwork- but sometimes it takes time for the bone marrow to respond. I don’t know what kind of neurological signs this pup had- but with a HCT that low I am surpirsed this pup can function at all.
Can you give us the results of the stool check and repeat CBC?
You always have some of the most interesting and challenging cases.
Thanks Randy. I like the way
Thanks Randy. I like the way you sum it up! I will follow up on this one and let you know.
Puppies normal hematocrit is
Puppies normal hematocrit is around 30-35% and will show a poorly regenerative response, so 15 is not that low. Parasites and poor nutrition highly probable but with the fluid-filled stomach, foreign body obstruction needs to be kept in mind. With the puppy being stunted there could also be a number of inborn hereditary metabolic disorders.
Thanks Remo. A recheck PCV
Thanks Remo. A recheck PCV was 12%. The fecal was negative. The owner did not want to pursue anything else and euthanized the dog. It had been her hope to be able to save the puppy with fluids and nutrition alone.