My parents live in Africa and their 9 year old female pekinese has been having panic attacks and allegedly suffered heatstroke in January -she nearly died and was at the hospital for 3 days. I say 'allegedly' because the vets still never gave a proper diagnosis nor did they do bloodwork, until last week upon my urging. The vets there are not as good as the vets here in the US, and I advised my parents to get a blood analysis asap and urinalysis done to see what is causing the problems with her. They got blood drawn but there was no urine in her bladder to test. The vets were very vague so my dad faxed me through her bloodwork results to me. I see there are some high and low flags, could anyone please give me some input so they can go in the right direction?
Female Pekinese, purebred, spayed, 9 years old, app. 6 pounds.
Testname:
Sample Materials and Evaluation - test value: Haemolysed
Geriatric Profile:
ALT: 26.00 U/l Range: 10.00-60.00 (normal)
ALP: 18.00 U/l (Low) Range: 100.00-250.00
Urea: 6.00 mmol/I Range: 3.60-8.90
Creatinine (serum) 85.00 umol/I (Low) Range: 100.00-130.00
Total Protein (serum) 65.00 g/l (normal) Range 53.00-75.00
Albumin 38.00 g/l (high) Range: 25.00-35.00
Globulins: 27.00 g/l (normal) range: 25.00-35.00
Glucose: 0.90 mmol/l (Low) range 3.30-5.50 (please note that glucose test done on serum may lead to inaccurate result)
Blood Count:
Red blood cell count: 8.48 x10^12/l normal Range: 5.50-8.50
Haemoglobin: 19.60 g/dl (high) Range 12.00-18.00
Haematocrit (PCV): 59.40 b/v(?) High Range 37.00-55.00
Mean cell volume (MCV) 70.10 fl normal Range 60.00-77.00
Mean cell haem.cons.(MCHC) 32.90 g/dl 32.00-36.00 Normal
White cell count 9.29 x10^9/l 6.00-15.00 normal
Platelet count 331.00 x10^9/l 200.00-500.00 normal
No urine received
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Thank you for info or direction you can give - all her vaccines are up to date and she didn't have Parvo Virus.
Question regarding canine bloodwork
Re: Question regarding canine bloodwork
Actually, the bloodwork looks pretty good, don't let high/low values fool you, most are just slightly above range and may be considered "high normal", and could have resulted in any number of things like stress, not having been fasted before bloodwork, hemolysis of samples or letting the samples rest for too long before testing. What looks obvious to me anyway, might be that the dog was dehydrated before testing. Not knowing the methods they used or if they handled the samples properly, it might be worth it to retest in about a month, providing no symptoms develop in the meantime.
I'm surprised at the heat stroke "diagnosis", being hospitalized, but no bloodwork done at the time. Were any other tests done at the time? How did the vets approach the treatment?
Other values weren't included in the chemistry profile, given the dog's age and prior events, a full blood profile should have been done, to include potassium, calcium, chloride, magnesium, cholesterol, amylase, lipase, creatine kinase, etc to determine muscle and heart function as well. A urinalysis should always be included in a full blood profile.
How do your parents describe the "panic attacks"? If these occured suddenly and for no apparent reason, I think I would be checking heart function, seizure activity, CNS problems or even potential tumor. But, before additional diagnostics are done for those, I would re-run a full blood profile for accuracy and comparison, include thyroid panel, urinalysis and an ECG/blood pressure check, xrays to check for bone or muscle problems. If the heatstroke was a true, confirmed diagnosis, it should be noted that many dogs having experienced one incident of heat stroke, can be susceptible to more of the same, so at this point, at least limit activity to short periods, do not walk or exercise in warm weather etc and monitor closely for exercise intolerance, weakness, lethargy.
Can the vet get a consult with another more experienced vet or vet university?
I'm surprised at the heat stroke "diagnosis", being hospitalized, but no bloodwork done at the time. Were any other tests done at the time? How did the vets approach the treatment?
Other values weren't included in the chemistry profile, given the dog's age and prior events, a full blood profile should have been done, to include potassium, calcium, chloride, magnesium, cholesterol, amylase, lipase, creatine kinase, etc to determine muscle and heart function as well. A urinalysis should always be included in a full blood profile.
How do your parents describe the "panic attacks"? If these occured suddenly and for no apparent reason, I think I would be checking heart function, seizure activity, CNS problems or even potential tumor. But, before additional diagnostics are done for those, I would re-run a full blood profile for accuracy and comparison, include thyroid panel, urinalysis and an ECG/blood pressure check, xrays to check for bone or muscle problems. If the heatstroke was a true, confirmed diagnosis, it should be noted that many dogs having experienced one incident of heat stroke, can be susceptible to more of the same, so at this point, at least limit activity to short periods, do not walk or exercise in warm weather etc and monitor closely for exercise intolerance, weakness, lethargy.
Can the vet get a consult with another more experienced vet or vet university?
..........Traci
Re: Question regarding canine bloodwork
Traci thank you for your help. My dad was taking her for a short walk when she started vomiting liquid with some blood, and there was blood leaking from her anus. He took her straight to the closest vet (let's call him VET A) who gave her an "anti nausea" (that's what he told my father) injection and said it was just a stomach virus. She got home with my dad and started going into convulsions. It was a Sunday afternoon and VET A (who has also refused to tell my father what injection he gave the dog) had closed, so her rushed her to the ER vet (VET B - he supposed to be the specialist in their areaTraci wrote:Actually, the bloodwork looks pretty good, don't let high/low values fool you, most are just slightly above range and may be considered "high normal", and could have resulted in any number of things like stress, not having been fasted before bloodwork, hemolysis of samples or letting the samples rest for too long before testing. What looks obvious to me anyway, might be that the dog was dehydrated before testing. Not knowing the methods they used or if they handled the samples properly, it might be worth it to retest in about a month, providing no symptoms develop in the meantime.
I'm surprised at the heat stroke "diagnosis", being hospitalized, but no bloodwork done at the time. Were any other tests done at the time? How did the vets approach the treatment?
Other values weren't included in the chemistry profile, given the dog's age and prior events, a full blood profile should have been done, to include potassium, calcium, chloride, magnesium, cholesterol, amylase, lipase, creatine kinase, etc to determine muscle and heart function as well. A urinalysis should always be included in a full blood profile.
How do your parents describe the "panic attacks"? If these occured suddenly and for no apparent reason, I think I would be checking heart function, seizure activity, CNS problems or even potential tumor. But, before additional diagnostics are done for those, I would re-run a full blood profile for accuracy and comparison, include thyroid panel, urinalysis and an ECG/blood pressure check, xrays to check for bone or muscle problems. If the heatstroke was a true, confirmed diagnosis, it should be noted that many dogs having experienced one incident of heat stroke, can be susceptible to more of the same, so at this point, at least limit activity to short periods, do not walk or exercise in warm weather etc and monitor closely for exercise intolerance, weakness, lethargy.
Can the vet get a consult with another more experienced vet or vet university?
). She was running a very high fever and he put her into an ice bath and gave her the following:1.11.2009 Consultation.
" Blood Smear.
" Injection.
" Baytril 5%
" Dexa 0,2P
" Drip.
" Oxygen.
" Adrenaline.
" Millophyll.
" Histasol I.
1.13.2009 Vav DA2ppi.
" Quantel CA.
1.14.2009 Blood Smear.
" Injection.
" Baytril 5%.
" Clopaman 1.
" Lenamet IN.
" Buscopan C.
" Ulsanic P/.
02.12.2009 Cortasone (Skin Allergy)
I agree that they should have included include potassium, calcium, chloride, magnesium, cholesterol, amylase, lipase, creatine kinase etc, as that is what is included when my kitties have their 6 monthly CBC. Honestly, the vets in Africa are not very good, and the university vets are very far away and the dog panics in the car.
Her panic attacks usually start when there is thunder or loud noises like gun shots, fireworks or cars backfiring - they are characterized by the following: she starts licking the blanket compulsively, then she starts to run around in circles in an agitated fashion, as though an ant has bitten her (but nothing has bitten her), then she climbs up my mother's shoulder and sits in her neck and shakes all over.
The current vet doesn't have a blood pressure machine with a cuff to measure BP, he listened with a stethoscope and said her heart was beating too fast (she was very scared). His suggestion to my father is to put her on blood pressure meds. Now I remember when I lived there long ago, I would always question the vets and argue about what was right for my cats - they hated me, and one even kicked me out of his office when I objected to the way he handled my cat. Thank heavens I moved here so my cats have the proper medical care they need, and the doctors here are mostly very caring and competent.
I have told my father not to take her for walks at all, she can play in the garden. I have also advised him to get the urinalysis done and ask about doing new bloodwork including the potassium, calcium, chloride, magnesium, cholesterol, amylase, lipase, creatine kinase etc that was not tested (and my dad says he asked the vet to test for everything - a full blood panel). I think this poor little dog was inbred by a breeder greedy for money, and she probably has genetic issues.
As you describe the prior event, it does not sound necessarily like heatstroke, but perhaps a serious infection, or internal injury or toxin. Too bad you don't know the medication given, when she went into seizures. That would tell a great deal, and would rule in/out the potential of a serious reaction to the medication, or, a seizure (unrelated to medications) as a result of something else entirely. The blood loss should have been concerning to the vet and he should have done a CBC and hematocrit right then and there. The ER vet did a much better job with at least choosing appropriate diagnostics and treating (I assume nothing was identified with the blood smear?) Did the vet determine where the blood was coming from?
The panic attacks you describe sound like hyperesthesia, which is generally difficult to pin-point a cause, but is almost always induced by external stimuli (noise, light, loud sounds etc). Sometimes it can be a pain response (muscle, spine, lumbar area, pinched nerve)
To a lesser extent, have fleas/mites/tick problems been ruled out?
The heart-racing at the exam doesn't mean much, since it could have been due to stress, however, your parents can try to determine this themselves at home, when the dog is in a relaxed state, and by using a clock (with a face, not digital). See How to Check Vital Signs, scroll to Heart Rate. Normal for dogs is 60-180 beats per minute. Anything significantly higher, after at least three attempts (twice or three times a day while dog is in resting state), demands a blood pressure check and ECG.
I think ultimately, I would suggest re-running a FULL chemistry profile, a new CBC, urinalysis, thyroid panel. If all check out ok, seriously consider xrays (to check for masses or inflammation, check size and shape of heart and other organs etc), blood pressure check and ECG. In a dog this age, and particularly her small breed, heart function should NEVER be missed and undetected.
The panic attacks you describe sound like hyperesthesia, which is generally difficult to pin-point a cause, but is almost always induced by external stimuli (noise, light, loud sounds etc). Sometimes it can be a pain response (muscle, spine, lumbar area, pinched nerve)
To a lesser extent, have fleas/mites/tick problems been ruled out?
The heart-racing at the exam doesn't mean much, since it could have been due to stress, however, your parents can try to determine this themselves at home, when the dog is in a relaxed state, and by using a clock (with a face, not digital). See How to Check Vital Signs, scroll to Heart Rate. Normal for dogs is 60-180 beats per minute. Anything significantly higher, after at least three attempts (twice or three times a day while dog is in resting state), demands a blood pressure check and ECG.
I think ultimately, I would suggest re-running a FULL chemistry profile, a new CBC, urinalysis, thyroid panel. If all check out ok, seriously consider xrays (to check for masses or inflammation, check size and shape of heart and other organs etc), blood pressure check and ECG. In a dog this age, and particularly her small breed, heart function should NEVER be missed and undetected.
..........Traci
Traci, thank you so much for your help. I have emailed my dad your input, and I'll update this thread if he is able to get further tests and feedback from the vet regarding this advice. She does not have fleas/ticks or mites - she is given Frontline and the vet shaved her fur off because it's so hot there and her coat was too thick for the heat.
I cannot thank you enough for your help.
I cannot thank you enough for your help.