A 9-year-old FS Labrador Retriever was presented for extreme restlessness (up all night), inability to get comfortable, panting, and shaking.
A 9-year-old FS Labrador Retriever was presented for extreme restlessness (up all night), inability to get comfortable, panting, and shaking.
- Owners reported appetite, urinations, and bowel movements have all been normal. No history of GI issues, no vomiting, and no known ingestion of toxins or foreign body.
- PE was unremarkable with the exception of a slightly tender abdomen.
- In-house CBC/Chemistry were within normal limits. Lat/VD abdominal rads showed some gas patterns but nothing too concerning.
- The patient was given a dose of Reglan and admitted for observation.
- Within an hour the symptoms we had been seeing, panting, shaking, and restlessness had subsided and the patient actually laid down and slept comfortably for a few hours.
- Upon waking the patient was walked and appeared slightly lethargic with her head down. Within minutes of a short walk to the doctor’s office to show them her now depressed condition (10 whole steps), the dog began to hold her left forelimb up and began to limp. She then proceeded to circle twice to the right and her color became muddy and slightly cyanotic. The patient was placed on O2 flow by and pinked up immediately. She then resumed her panting and trembling as she did earlier.
Comments
I would be worried about
I would be worried about thromboembolic disease (TED) here sonogirl or invasive adrenal tumor like a pheo, maybe cardiac paroxysmal arrhythmia. Needs CT/MRI, ECG, serial blood pressure and abdominal sonogram to look for causes of TED or invasive adrenal tumor. Look for infectious and causes of vasculitis especially if sudden onset. Shotgun doxy/clindamycin and aspirin or plavix?? I would really encourage at least a dual cavity sonogram to rule out major organ disease and at least localize to infectious or CNS of the abdomen and heart are clean. “If its not in abdomen or the chest its likely to be metabolic, infectious or in the CNS.” That’s my bleak attempt at poetry…veterinary haiku???:)
I’m sure Remo would have more input here
I would be worried about
I would be worried about thromboembolic disease (TED) here sonogirl or invasive adrenal tumor like a pheo, maybe cardiac paroxysmal arrhythmia. Needs CT/MRI, ECG, serial blood pressure and abdominal sonogram to look for causes of TED or invasive adrenal tumor. Look for infectious and causes of vasculitis especially if sudden onset. Shotgun doxy/clindamycin and aspirin or plavix?? I would really encourage at least a dual cavity sonogram to rule out major organ disease and at least localize to infectious or CNS of the abdomen and heart are clean. “If its not in abdomen or the chest its likely to be metabolic, infectious or in the CNS.” That’s my bleak attempt at poetry…veterinary haiku???:)
I’m sure Remo would have more input here
Thanks Dr. Lindquist! This
Thanks Dr. Lindquist! This was quite puzzling to observe yesterday. We thought for a moment she was possibly having a reaction to the Reglan, but her symptoms resumed as they had been for the owners. I can’t wait to see how she is doing this week. I will try to post an update when I have one.
Thanks Dr. Lindquist! This
Thanks Dr. Lindquist! This was quite puzzling to observe yesterday. We thought for a moment she was possibly having a reaction to the Reglan, but her symptoms resumed as they had been for the owners. I can’t wait to see how she is doing this week. I will try to post an update when I have one.
Regarding the cyanosis: If
Regarding the cyanosis: If there´s no heart murmur it is unlikely to origin from cardiac disease (a shunt like VSD, ASD, PDA would have become obvious earlier in life and pulmonary edema causing cyanosis in an old dog is usually due to mitral valve disease or DCM). Primary airway disease or pulmonary pathology is still possible. Some dogs develop cyanosis of the tongue simply because of excessive panting – without an underlying cardiac or respiratory disease. And: Regarding the clinical symptoms I would also include orthopedic/spinal disease into the list of differential Dxs. Limping of the forelimb can also be due to cervical disc disease. This is usually very painful, dogs walk with the head down, pant and cannot come to rest….
I´m convinced you will come to a diagnosis!
Best Regards
Peter
Regarding the cyanosis: If
Regarding the cyanosis: If there´s no heart murmur it is unlikely to origin from cardiac disease (a shunt like VSD, ASD, PDA would have become obvious earlier in life and pulmonary edema causing cyanosis in an old dog is usually due to mitral valve disease or DCM). Primary airway disease or pulmonary pathology is still possible. Some dogs develop cyanosis of the tongue simply because of excessive panting – without an underlying cardiac or respiratory disease. And: Regarding the clinical symptoms I would also include orthopedic/spinal disease into the list of differential Dxs. Limping of the forelimb can also be due to cervical disc disease. This is usually very painful, dogs walk with the head down, pant and cannot come to rest….
I´m convinced you will come to a diagnosis!
Best Regards
Peter
Thank you Dr.Modler, I
Thank you Dr.Modler, I initially thought it was pain too, but then the odd symptoms. It makes sense with regards to back pain as you described with her head down and then the limping. She was re-admitted just yesterday so I hope she is feeling better or we at least got her owners an answer.
Thank you Dr.Modler, I
Thank you Dr.Modler, I initially thought it was pain too, but then the odd symptoms. It makes sense with regards to back pain as you described with her head down and then the limping. She was re-admitted just yesterday so I hope she is feeling better or we at least got her owners an answer.