Category: Dog Disease Treatment

Diagnosis and treatment of a dog with pyometra

Abstract

Canine pyometra refers to a disease in which a large amount of pus accumulates in the uterine cavity of dogs, accompanied by abnormal endometrial hyperplasia and bacterial infection. According to whether the cervix is open or not, it can be divided into closed type and open type. The disease is more common in older animals older than 7 years, and often occurs 2 to 4 weeks after estrus. The clinical manifestations are depression, decreased appetite, polydipsia and polyuria, vomiting, vulvar discharge (open type), weight loss, and increased abdominal circumference.
In this paper, the canine atresia pyometra was mainly treated with surgery and achieved a good prognosis. The cases are organized as follows.

1: Patient Information

1.Name: Kimi
2.Breeds: Schnauzer
3.Age: 7 years old
4.Gender: female
5.Diagnosis time: March 2022

2: Medical History Investigation

1.Diagnose the problem: lethargy, lack of activity, enlarged stomach, vomiting, fever
2.Main statement: The dog has a loss of appetite for about a week, likes to lie down, does not like to move, the stomach seems to be a little bigger, the stool is less, frequent urination, vomiting 3 times, not neutered, the estrus time is extended this year, deworming and vaccination on time vaccine. The owner gave the dog amoxicillin-clavulanate potassium and it did not improve. Today, the owner found that its ears became hot, and then brought it to our hospital for treatment.

3: Physical Examination

1.Overall inspection
BCS4/9 Good body condition, poor skin tone
2.General inspection
BW: 7kg, T: 39, 8, HR90 times/min, RR: 25 times/min
3.System check
Auscultate heart rhythm, no obvious heart murmur, mild abdominal pain on palpation, tubular contents, clean anus, no obvious abnormality of vulva, dry hair, excessive licking of limbs, dehydration assessment 5
4.Laboratory tests
Inspection items: blood routine, acute reaction protein, biochemistry, image X-ray and abdominal B-ultrasound

Blood Routine

Project

Test Result

Reference Range

WBC

31.2×10^9/L

6-16.9

LYM#

7.5×10^9/L

1.1-6.3

GRA#

22×10^9/L

3.30-12.00

RBC

5.2×10^12/L

5.50-8.50

HGB

11.9g/dl

12.0-18.0

HCT

49.1%

37.0-55.0

MCHC

34.0g/dl

30.0-36.9

PLT

167K/μL

175-550

Acute inflammatory

Project

Test Result

Reference Range

CRP

196mg/L

<20mg/L

Biochemical

Project

Test Result

Reference Range

TP

24.1g/l

23-40

ALB

70.3g/l

52-82

GLOB

46.2g/l

23-45

A/G

0.52

 

ALT

98u/l

5-125

ALP

614u/l

17-212

GREA

719.0umol/l

44-159

BUN

37.78umol/l

2.5-9.6

BUN/Creatinine

52.548

16-218

Blood Glucose

5.29umol/l

4.11-7.94

X-ray
Diagnosis and treatment of a dog with pyometra

B Ultrasound
Diagnosis and treatment of a dog with pyometra

Routine blood anemia, inflammation, blood smear a large number of neutrophils, acute reaction protein severe acute inflammation infection, imaging X-ray dogs can see homogeneous tubular images in the abdomen and posterior abdomen, multiple mixed echoes in front of the bladder displayed by B-ultrasound Liquid dark area. Combined with the clinical history, the direction of diagnosis is pathological uterine lesions in the reproductive system, and azotemia caused by acute loss of kidneys. An increase in alkaline phosphatase will prompt steroids, and further consideration needs to be given to endocrine diseases caused by estrogen.

4: Diagnosis and treatment

1.Diagnosis: canine atresia pyometra
2.Treatments:
Surgical treatment: Surgical removal of pathological ovaries and uterus
Medical Treatment: Kidney Loss

Before surgery:
1.In view of the fact that the dog is dehydrated and has low blood pressure, a routine rehydration was performed first to increase blood pressure and improve azotemia and acid-base balance in the body.
2.Give cephalosporin antibiotics 2 hours before the operation.
3.Preoperative blood coagulation test: normal

During surgery:
Open the dual forelimb veins, shave and disinfect the surgical department, prepare blood pressure and heart rate detection equipment, and emergency medicine and equipment for surgery
1: Intravenous access 1: iv: Slow intravenous infusion after dilution of lidocaine to maintain a stable heart rhythm and have a certain sedative and pain relief effect
2: Intravenous access 2: iv: Lingner lactate to maintain blood pressure

After surgery:
Pain relief, antibacterial, anti-inflammatory and wound care are required
1~5 days medication
1: iv: 0.9% NACL100ML + cephalosporin third generation 0.7ML
2: iv: G/S100ML+ energy group
3:iv:LRS150
4: iv: Lidocaine 5ML+0.9NACL% 50ML
5: sc: Enrofloxacin 0.7ML
6: sc : Butorphanol 0.7ML
7: sc: vitamin B complex 0.7ML
8: Bailing Jinfang Wound Spray
9: Headgear
10: Surgical gown
11: Hospital monitoring
12: PO kidney medicine × 14

5: Notes

1. Although the diseased uterus and ovaries are surgically removed, there is still a dangerous state after the operation. After the operation, you still need to be hospitalized for 24 to 72 hours to observe the breathing, heart rate, blood pressure, etc.
2. Due to the infection of the uterine Asahi endotoxin to the whole body, there may still be blood sepsis after the operation, and regular blood routine and blood gas analysis are required after the operation.
3. Lesions in other systems may be secondary to the operation, such as renal failure, liver, spleen heterotopic myeloid tissue formation, hemorrhage and atrophy of the adrenal cortex and medulla, and the postoperative risk period is one week. Death may occur.
4. Antibiotic treatment should be rechecked at least five days after the operation, and the medication can only be stopped after the blood indicators are qualified.
5. Inflammatory response syndrome may cause systemic hypovolemic shock
6. Any changes during hospitalization require adjustment of medication
7. There may still be a small amount of secretions from the vulva in the early stage after the operation. Tell the owner in advance that after the treatment, the infection will be controlled and it will improve.
8. Review metrics based on recovery
9. Wound care requires daily routine dressing changes, and stitches are usually removed within one week to ten days.

6: Prognosis

Ovariohysterectomy is the best way to cure this disease as soon as possible for closed pyometra. After the operation, the dog’s desire to defecate and defecate was normal, and the wound returned to normal. The sutures were removed and discharged after 10 days. The follow-up visit was normal one week after discharge, and the prognosis was good.
Diseased Uterus
Diagnosis and treatment of a dog with pyometra

The fifth day of surgery
Diagnosis and treatment of a dog with pyometra

7: Pathogenesis and Prevention of Diseases

Pyometrium is the accumulation of purulent substances in the uterine cavity. It is a cystic endometrial hyperplasia and inflammation. Among them, the incidence is more frequent in elderly dogs, dogs without production and dogs with production, and the incidence rate will also increase with a history of hormone therapy. The disease mainly occurs in the late stage of estrus, when progesterone promotes the growth of endometrium and secretion of glands, and reduces the activity of uterine smooth muscle. Excessive progesterone will cause the uterine glandular tissue to become cystic edema and thinner. At the same time, with the exudation of lymphocytes and cells, fluid will accumulate in the uterine glands and uterine cavity, and eventually develop into cystic uterus Membrane hyperplasia. Progesterone can inhibit the contraction of uterine smooth muscle and hinder the normal excretion of the uterus. Progesterone can also inhibit the bacterial proliferation of white blood cells against bacterial infection, resulting in pyometra. Estrogens increase the number of uterine progesterone receptors, so use of estrogens during estrus increases the risk of pyometra. Uterine tumors can also cause discharge of uterine secretions, causing pyometra. Infection increases morbidity and mortality in pyometra. According to whether the cervix is open or not, the disease can be divided into two types: atresia and open. Dogs with an open cervix will discharge viscous purulent secretions, often with blood. In sick dogs with cervical atresia, the symmetrical distension of both sides of the lower abdomen is especially obvious, and the atresia uterine asphyxia can easily lead to animal sepsis, shock and death. The prevention of the disease suggests that female dogs who do not plan to breed should be sterilized as soon as possible, which can not only prevent pyometra but also reduce mammary gland diseases.

The diagnosis and treatment of Canine Babesiosis

Abstract

Parasites of the genus babesia is a type of blood protozoans that can infect red blood cells of vertebrate hosts. Two species of babesia have been reported to infect dogs: Babesia Canis and Canine Babesia gibsoni.Traditionally, these creatures have been distinguished by their appearance on blood-stained smears.The firstly creatures are larger, appearing as two-leafed piriform creatures, often in pairs, about 4-5 um in length. The organisms of Canine Babesia gibsoni are smaller (1-2.5 um in diameter) and are round, oval, or ring-shaped in red blood cells, usually as a single plant. Babesia Canis is endemic in Europe, southern Africa, Asia and the Americas. There are 3 subtypes of Babes:B. canis canis, B. canis vogeli, and B. canis rossi. These strains differ in virulence, geographic location, and tick vectors, but are identical in appearance. In the United States, the most common strain is Lactobacillus Canis, which is the least pathogenic. Although severe hemolytic anemia, thrombocytopenia and life-threatening diseases have been reported in young dogs, severe parasitism in dogs, and transfusions of infected blood in dogs.In the United States, most dogs infected with B. Canis are subclinical carriers. Although not highly pathogenic, the canine B. canis vogeli organism appears to be endemic in the southeastern United States, particularly among greyhounds. A recent study distinguished three subspecies of Babesia Canis by polymerase chain reaction and restriction enzyme analysis, suggesting that they may in fact be closely related, but distinct and independent species. The most pathogenic dog type B is endemic to South Africa. Babesians are found in parts of Europe and Asia and are considered intermediate pathogenic.So it is a big challenge to diagnose of this disease.The purpose of this article was to introduce the current diagnostic evidence and the relating to the treatment of Canine Babesiosis in dogs.

Key words : Canine Babesiosis, diagnosis, treatment

Basic information

Name:HUAN HUAN
Breed:Golden Retriever
Sex:Female (castrated)
Age:4 years old
Body weight:25.5kg
History:outdoor activities,complete vaccination,no deworming,gastroenteritits one year ago
Owner took her to countryside half month ago, playing in the outdoors during that time.Two days ago,the dog started to appear lethargic and weak.Owner found it walk in a incoordinate post when walking dog.So decide to took her to the hospital.Vaccinate history is completed.No deworming in this year.

Physical examination

Body weight 25.5kg,temperature 39.7℃,respiratory rate was 80/min, heart rate:110 beats/min.No obvious murmurs in breathing .Mouth mucosa was pale,capillary refill time(CRT)<2s, body condition score(BCS)was 6/9 which can no touch the ribs in palpation.The patient was presented with depression dry coat and nose. Abdominal palpation was no obvious abnormal findin in abdomen.There were mild dental calculus and gingivitis in oral examination.Multiple areas of skin were soft. Obvious dehydration was not found.

Laboratory examination
Complete Blood Count (CBC) examination for Day 1

Project

Result

Reference Range

WBC

11.8×103/μL

6.0~17.0

RBC

1.67×106/μL

5.5~10

HGB

3.2g/dL

12.0~18.0

HCT

10.7%

37~55

MCV

64.1fL

60~77

MCH

19.2pg

19~24.5

MCHC

29.9g/dL

30~37

PLT

148

200~500

LYM%

25.4%

12~30

OTHR%

68.8%

60~86

EO%

6.0%

2~10

LYM

3.0

1.5-7

OTHR

8.1

2.5-12.5

EO

0.7

0-1.5

WBC

11.8×103/μL

6.0~17.0

RBC

1.67×106/μL

5.5~10

HGB

3.2g/dL

12.0~18.0

Interpretation: No obvious abnormality was observed in the leukocyte line. Severe low red blood cell count and HCT indicate positive cell hypochromic anemia and low blood volume, which may indicate iron deficiency anemia or anemia caused by chronic diseases Low platelet count

Idexx Catalyst biochemistry CHEM15

Project

Unit

Reference Range

Result

ALP

U/L

23-212

76

ALT

U/L

10-125

23

BUN

mmol/L

2.5-9.6

3.5

Ca

mmol/L

1.98-3.00

2.15

CRE

umol/L

44-159

45

GGT-γ

U/L

1-10

1

GLU

mmol/L

4.11-7.94

5.48

TP

g/L

52-82

71

TBIL

umol/L

0-15

9

ALB

g/L

23-40

26

TCHO

mmol/L

2,84-8.27

4.84

PHOS

mmol/L

0.81-2.19

1.15

GLOB

g/L

25-45

46

ALB/GLOB

  

0.6

BUN/CRE

  

19

Interpretation:There was a slight increase in globulin, no obvious abnormalities in other biochemical indicators, no obvious specificity and sensitivity, suggesting the existence of inflammatory diseases in the body
The result of the CRP testing

Project

Result

Reference Range

CRP

122.0mg/L

<10mg/L

Interpretation: The increased of CRP significantly, indicating the existence of serious acute inflammation or tissue cell damage.
Blood agglutination test

Project

Result

Reference Range

APTT

22

15-43

PT

10.2

5-16

Microscope of the blood smear
The diagnosis and treatment of Canine Babesiosis

Interpretation:Multiple nucleated red cells were seen at high field.Red blood cells of different sizes, a large number of spherical red blood cells, a small number of oral red blood cells. The presence of “ring” like contents in multiple red blood cells was observed.

Project

Unit

Reference Range

Result

pH

7.25-7.400

7.384

pCO2

mmHg

33.0-51.0

31

Hct

%

24-40

12

Na+

Mmol/L

139-150

140

K+

Mmol/L

2.9-4.2

3.4

Cl-

Mmol/L

106-127

113

AnGap

Mmol/L

10-27

16

The PCR result of infectious examination

Project

Result

Babesia gibsoni

(+)

Babesia canis

(-)

HGA

(-)

Ehrlichia canis

(-)

Diagnosis

Canine Babesia gibsoni
The diagnosis methods in Canine Babesia gibsoni usually used in clinical are consist of the physical examination findings history, laboratory examination such as complete blood count, cytology. Biochemistryprofile,urinalysis,polymerase chain reaction(PCR)assays.And we will also take serology and radiography examinations to have a full understanding of the patients.In general speaking,the evidence of anemian,  the”ring-like”performance in the red blood cell,the highly elevate of the CRP and hyperglobulinemia are indicated to the babesia infection .
Although it is relatively easy to diagnose babesia under the microscope performance with “ring” like which can be directly seen from blood smear, for different species and strains, the pathogen may not be detected in the first time. Therefore, more clinical auxiliary examinations, such as urine detection and abdominal ultrasound examination, are required. On the one hand, more detailed of the pathogen conditions can be screened to prevent missed diagnosis happening. Further more, it could be found to make us suspect babesiosis early.

Treatment

1.Blood transfusions 2mL/kg ivgtt
Relieve tissue hypoxia through blood transfusion: Blood type detection and cross-matching test were conducted actively in donor dogs. The red blood cell volume of 2ml/kg·BW was increased by 1%, and the dose of whole blood needed to be input was calculated.The elevation of HCT is limited because the affected dog is too heavy to get more whole blood for infusion
2.Gastroprotectants of omeprazole:1mg/k’g s.c q24hrs
3.Diminazene aceturate :3.5mg/kg i.m
4.LRS + 0.9% NaCl solution(1:1) 60mL/kg ivgtt
5.Clopidogrel 2mg/kg p.o q24hrs

The principle therapy is to manage to eliminate the pathogen as possible and maintain body function.
For the later stage of treatment and the period of acute infection, it is still recommended to carry out regular CBC and PCR examination, because any treatment can not completely eliminate the insect body, and regular deworming is needed to prevent secondary infection.Although the mechanism of action of drugs on babesiosis is largely unknown or not studied in detail, atovaquone and azithromycin are more recommended for babesiosis in dogs with relatively less side effects, but it has been suggested by veterinarians that the recurrence rate of treatment with this regimen is higher than treatment with triazmidine alone. If triazamidine is used alone for treatment, caution should be exercised with repeated administration because triazamidine has a narrow safety range, many side effects, and increased neurological and parasympathetic toxicity at cumulative doses of more than 7mg/kg, and repeated administration within 6 weeks is not recommended.For the treatment of babesia gibsoni, a new drug regimen has been proposed in recent years: Clindamycin combined with triazamidine and midoca. The specific mechanism of action is not completely clear, and there are few clinical trials, which need further study and research.Severe hemolytic anemia may require blood transfusion. The use of glucocorticoids is controversial because it may aggravate parasitic diseases. Assess and correct dehydration and acidosis. Start special treatment for any co-morbid disease (e.g., Eliktic disease, leishmaniasis, hepatic zoonosis). And we should not ignore the treatment of serious complications such as acute renal failure,pancreatitis,DIC.
The prognosis of this case is good,and recovery on day 7.In the report,the prognosis depends on the strain of infection and the immune capacity of the patient. Individuals with splenectomy usually have a poor prognosis.

The examination during the therapy
Complete Blood Count (CBC) examination after therapy

Project

DAY 1

DAY 2

Reference Range

WBC

11.8

14.7

6.0~17.0×103/μL

RBC

1.67

3.41

5.5~10×106/μL

HGB

3.2

6.6

12.0~18.0g/dL

HCT

10.7

22.0

37~55%

MCV

64.1

64.5

60~77fL

MCH

19.2

19.4

19~24.5pg

MCHC

29.9

30.0

30~37g/dL

PLT

148

304

200~500

LYM%

25.4

12.4

12~30%

OTHR%

68.8

77.3

60~86%

EO%

6.0

10.3

2~10%

LYM

3.0

1.8

1.5-7

OTHR

8.1

11.4

2.5-12.5

EO

0.7

1.5

0-1.5

Conclusion

Definition and Etiology
Babesiosis is caused by hematoprotozoa which is inside the red blood cells. One to five species of babesia can be divided into large and small. Both dogs and cats can be infected with both viruses, although cats are rarer than dogs. Babesia is the second most common mammalian blood parasite in the world.Transmission can be mainly through tick bites, blood contamination (e.g. from a blood donor, fighting), or transplacenta. Once the host is infected, the incubation period is 7-21 days. The tick species associated with transmission are ridgehead, ixodes, dermis, haemaphysalis and hyaluronoma ticks. The most common vector in the United States is the haemaphysalis.
The babesia inside the erythrocyte is ingested by a vector, usually ticks of the ixodidae family, from the blood of an infected host. Infected red blood cells are usually digested and destroyed in the tick’s midgut. A few surviving cells turn into gametes, followed by zygotic fusion. Then they invade the midgut epithelium. The fertilized egg undergoes meiosis, transforms into a motile oocyte, and passes through the carrier’s blood sac. Babesia reproduce asexually, which causes sporospores to spread to all organ systems within the carrier, where they remain for life. Interestingly, ticks infected with babesia tend to mature less, although some ticks are developing a tolerance to the protozoa. After spreading to different organ systems, macrobabesia can be transprogenically transmitted to infect future carrier offspring. The salivary glands are the most critical of the organs into which the sporospores enter, as they become the source of future infections. Within the salivary glands Babesia undergoes a final stage of replication to produce spores. These spores enter the host through saliva during the vector’s bloodsucking on the host. The infection process may require vector feeding for 2-3 days. Sporozoites enter the red blood cells of the host and multiply by binary fusion. The reproduction and reproduction of babesia in the blood leads to the clinical symptoms of the disease. These signs are mainly associated with hemolytic anemia and thrombocytopenia. Pathogenicity varies from strain to strain. Infection may be more severe and may occur clinically in patients with prior splenectomy or splenectomy.
Some infections are subclinical. When clinical disorders occur, there are usually two forms, whose name is hemolytic anemia (most common) and multiple organ dysfunction (rare). The most severe clinical form is usually caused by Echinococcus Canis. Occasionally, disseminated intravascular coagulation (DIC) may occur with hemolytic and vascular damage, followed by platelet destruction and clotting factor depletion.

Preventive Measures
For many cases,the most important thing is to prevent the disease such as deworming on time especially for the situation that walking dogs outdoors,instead of treating.Topical and environmental acaricide prophylactics can be used to minimize exposure to tick vectors. Examples include: 1) Afozoolana (Nexguard) was shown in a small study to prevent transmission and clinical development of canine babesiosis for 28 days after a single treatment. 2) In two small studies, lotillaner (Credilio) provided 100% protection against B. Canis infection during experimental tick infection. 3) In another small study, Babesia Canis infection is prevented when Simparica was administered 21 or 28 days prior to tick exposure. 4) Oral and oral fluramide (Bravecto) can also prevent transmission of B. Canis from infected ticks.) Combination products containing fipronil and permethrin (Frontline) are also valid.
Carefully assess pets after exposure and remove ticks promptly. Testing blood donors is necessary before using them. Vaccines using soluble parasite antigen (SPA) of different species of babesia have been used in the past, but with varying efficacy, probably due to the genetic diversity of the parasite. A new form of this vaccine is being studied, which utilizes SPA’svaccine-challenged supernatant. This approach was moderately successful in a small study of dogs.

A case of immune thrombocytopenia of canine

Abstract

Primary immune thrombocytopenia (IMT) is a cause of severe thrombocytopenia in dogs which involves the destruction of platelets by type II hypersensitivity (antibody-dependent cytotoxicity), a mechanism similar to that previously described in immune-mediated hemolytic anemia. If the truly auto-antibodies bind to the structural components of the platelet membrane, thrombocytopenia is inherently autoimmune in the absence of the underlying disease, The disease is primary immune-mediated thrombocytopenia (IMTP) or autoimmune thrombocytopenia (AITP). AIHA or AITP may occur simultaneously (Evans syndrome) or as part of the multi-system autoimmune disease systemic lupus erythematosus (SLE). Alternatively, antibodies may bind to the surface of platelets secondary to infection or administration, as described in IMHA. Immunosuppressive corticosteroids are often used to treat ITP, but treatment failure may occur. Immunomodulatory and non-corticosteroid immunosuppressive drugs may improve the outcome of treatment, either alone or in combination with corticosteroids. In this case, thrombocytopenia is considered primary.The purpose of this article was to introduce the current diagnostic evidence and the relating to the treatment of ITP in dogs with immunomodulatory and immunosuppressive regimens.

Key words: immune thrombocytopenia,canine.

Basic information

Name:XIAO GUI
Breed:Poodle dog
Sex:Female (not-castrated)
Age:4 years and 5 months old
Body weight:2.5kg
History:dietary habit with meat and mankind food for a long tern
Upon initial presentation,the dog started to appear lethargic and weak.Owner found it vomit and become worse recently.The day before the examination,XIAO GUI had no appetite at all,and was found ecchymoses in the skin.So took her to the hospital.Vaccinate history is completed.No deworming in this year.

Physical examination

Body weight 2.5kg,temperature 38.7℃,respiratory rate was 32/min,heart rate:102 beats/min、mouth mucosa was pale,capillary refill time(CRT)<2s,body condition score(BCS)was 3/9. The patient was presented with depression.dry coat and nose.Abdominal palpation was found nervous and increased of abdomen. There were mild dental calculus and gingivitis in oral examination.Multiple areas of ecchymoses were found on the skin of back and ventral skin. Obvious dehydration was not found.

Laboratory examination
Complete Blood Count (CBC) examination for Day 1

Project

Result

Reference Range

RBC

6.29

5.65-8.87

HCT

43.8

37.3-61.7

HGB

14.9

13.1-20.5

MCV

69.6

61.6-73.5

MCH

23.7

21.2-25.9

MCHC

34

32-37.9

RDW

16.5

13.6-21.7

RETIC

78.6

10-110

WBC

8.75

5.05-16.76

NEU

6.5

2.95-11.64

LYM

1.33

1.05-5.10

MONO

0.82

0.16-1.12

EOS

0.1

0.6-1.23

BASO

0

0-0.1

PLT

0

148-484

MPV

10.9

8.7-13.2

PCT

0

0.14-0.46

 The result of the biochemistry CHEM15 for Day 1

Project

Result

Reference Range

GLU

5.04

4.11-7.95

CREA

63

44-159

BUN

5.4

2.5-9.6

BUN/CREA

21

 

PHOS

1.67

0.81-2.2

CA

2.18

1.98-3

TP

60

52-82

ALB

30

23-40

GLOB

30

25-45

ALB/GLOB

1

 

ALT

31

10-125

ALKP

11

23-212

GGT

0

0-11

TBIL

0

0-15

CHOL

3.56

2.84-8.26

Blood agglutination test

Project

Result

Reference Range

APTT

28

15-43

PT

9.1

5-16

Microscope of the blood smear
A case of immune thrombocytopenia of canine
Imageological examination of Ultrasonic examination
A case of immune thrombocytopenia of canine
The ultrasonic image of spleen,we can see a 1.22cm x 2.00 cm mass in the spleen,there was a possibility of tumor which need further examination
A case of immune thrombocytopenia of canine
The ultrasonic image of the liver.We can see performance of cholestasis in the gall bladder,there was a possibility of the early stage of cystic mucocele.

Imageological examination of radiography test
A case of immune thrombocytopenia of canine
The lateral radiography image of the thorax and abdomen,there is no obvious abnormal finding.

Diagnosis

Immune-Mediated Thrombocytopenia
The diagnosis methods in immune-mediated thrombocytopenia usually used in clinical are consist of the physical examination findings or history,laboratory examination such as complete blood count,cytology.And we will also take biochemistry and radiography examinations to have a full understanding of the patients.Platelet tests,anti-platelet antibody test,bone marrow evaluation,coagulation tests,biomarker assays can have a better indicated to detect it but costing time and expensive in reality.Heart worm test is necessary in some area especially the deworming dogs.
Clinical signs of hemorrhage are the first commonly historical and physical abnormal findings in IMT.Besides,the patient may be presented with vomit,hematochezia,epistaxis,fever,paralysis,seizures and some neurologic signs.In the CBC report,we can find that there is a low platelet count and we can not find the platelet under the microscope. The patient of IME are found significantly lower of platelet counts compared with other causes of thrombocytopenia.

Treatment

1.Doxycycline:5mg/k’g po q24hs
2.Gastroprotectants of omeprazole: 1mg/k’g s.c q24hs
3.Immunosuppressive therapy of prednisolone: 1mg/kg po q12hrs

The principle therapy is to manage hemorrhage and maintain a platelet count,treating the inciting cause when possible.Specific therapy is giving immunosuppressive agents to reduce the destruction of antibody-coated platelets by the splenic macrophages.Supportive therapy is giving gastrointestinal protection drugs to prevent the hemorrhage of digestive tract.For the anemic patients,it may require a blood transfusion.Doxycycline is usually used in the prior to infectious disease screening results.The process were mentioned below,and the situation and the symptoms of the patient become better during the treatment.

The examination during the therapy
Complete Blood Count (CBC) examination for Day 2

Project

Result

Reference Range

RBC

4.29

5.65-8.87

HCT

29.3

37.3-61.7

HGB

10.4

13.1-20.5

MCV

68.3

61.6-73.5

MCH

24.2

21.2-25.9

MCHC

35.5

32-37.9

RDW

15.1

13.6-21.7

RETIC

12.4

10-110

WBC

6.88

5.05-16.76

NEU

4.65

2.95-11.64

LYM

0.95

1.05-5.10

MONO

1.19

0.16-1.12

EOS

0.05

0.6-1.23

BASO

0.04

0-0.1

PLT

74

148-484

MPV

20.2

8.7-13.2

PCT

0.15

0.14-0.46

Complete Blood Count (CBC) examination for Day 5

Project

Result

Reference Range

RBC

4.24

5.65-8.87

HCT

29

37.3-61.7

HGB

10.1

13.1-20.5

MCV

68.4

61.6-73.5

MCH

23.8

21.2-25.9

MCHC

34.8

32-37.9

RDW

17.1

13.6-21.7

RETIC

96.2

10-110

WBC

8.73

5.05-16.76

NEU

5.19

2.95-11.64

LYM

1.62

1.05-5.10

MONO

1.91

0.16-1.12

EOS

0.01

0.6-1.23

BASO

0

0-0.1

PLT

459

148-484

MPV

17

8.7-13.2

PCT

0.78

0.14-0.46

Complete Blood Count (CBC) examination for Day 10

Project

Result

Reference Range

RBC

4.93

5.65-8.87

HCT

33.8

37.3-61.7

HGB

11.1

13.1-20.5

MCV

68.6

61.6-73.5

MCH

22.5

21.2-25.9

MCHC

32.8

32-37.9

RDW

20.3

13.6-21.7

RETIC

285.0

10-110

WBC

13.84

5.05-16.76

NEU

9.62

2.95-11.64

LYM

2.34

1.05-5.10

MONO

1.74

0.16-1.12

EOS

0.08

0.6-1.23

BASO

0.06

0-0.1

PLT

368

148-484

MPV

15.6

8.7-13.2

PCT

0.57

0.14-0.46

Conclusion

Immune-mediated thrombocytopenia (IMT) refers to immune-mediated platelet destruction. Thrombocytopenia occurs when platelet destruction exceeds the number of platelets produced by megakaryocytes in the bone marrow.IMT is a primary or secondary disease. Primary IMT has no identifiable underlying cause of platelet destruction. Primary forms are more common in dogs than cats, although neither form is common in these species. In a study of 871 dogs with thrombocytopenia, IMT accounted for only 49 cases (5.6%). There are many potential causes of secondary IMT, These include medication, leptospirosis, Ehrlichiosis, New Ricker’s disease, Rocky Mountain spotted fever, leishmaniasis, Babesiosis, systemic mycosis, Bartontonia, hepatic zoonosis, canine empidemic virus, canine infectious hepatitis, feline infectious peritonitis, feline leukemia virus (FeLV), feline immunodeficiency virus, feline panleukopenia, bacterial infection, cystitis , pyelonephritis, primary bone marrow diseases, tumors (such as lymphoma), systemic lupus erythematosus, haemophilus mycoplasma, anaplasmosis, heartworm disease, bee poisoning, blood transfusion reactions, and other immune-mediated diseases (such as IMHA) .Note that recent vaccinations have been cited as a potential cause of IMT, but the relationship has not been fully established. In a study of 44 dogs with IMT, there was no significant difference in prevalence between the recently vaccinated patients and the control group. More research may be needed to better prove or disprove the association.

Pathophysiology
The pathogenesis of dogs and cats are not well understood. Much of what known is  inferred from a person’s IMT. The typical characteristic of IMT is the increasing of platelet autoantibodies. The destruction of platelets by MPS increased. Impaired production of megakaryocytes and platelets.The life of Platelet expectancy reduced. IMT is complex which involves B – and T-cell-mediated platelet destruction.

First,the platelet autoantibodies (i.e. major of IgG) bind to the surface of the platelet, causing MPS to destroy healthy platelets. This process is mediated by platelet coating by macrophage Fc receptor binding antibodies. T cells also contribute to platelet destruction, primarily Th1 and Th17 immune responses. The immune regulation that maintains self-tolerance (such as T and B regulatory cells) is also usually abnormal, leading to the persistence of anti-platelet immune responses.

The circulating platelet life of IMT patients is usually less than 1 day. The spleen is the main site of immune-mediated platelet destruction, with a destruction rates up to ten times that normal, senescent platelet consumption. Because antibody-bound platelets are cleared by MPS and not by the liver, liver TPO release is not triggered, thus slowing the rate of platelet reproduction.

Bone marrow accelerates platelet destruction by increasing the number of megakaryocytes. Thrombosis can increase to five times the normal rate. In IMT patients, however, platelet autoantibodies (in addition to unreleased TPO) cross-react with megakaryocytes, and thrombogenesis is often further weakened. Patients with IMT may develop megakaryocyte thrombocytopenia (i.e. megakaryocyte hypoplasia) secondary to immune-mediated destruction of megakaryocytes, although this is uncommon.

It is also worth noting that in canine patients with IMT, circulating autoantibodies may cause platelet dysfunction (i.e., thromboembolism) in addition to destroying platelets. However, studies have shown that surviving circulating platelets often have normal or enhanced ability to stop bleeding, possibly due to the large number of megaloplatelets (i.e., large young platelets). It is not known if these problems also apply to cats with IMT.

Prevalence and Signalment
Immune-mediated thrombocytopenia accounts for about 5-15% of canine thrombocytopenia cases. In a study of 61 thrombocytopenic dogs, 57% were diagnosed with primary IMT and 28% with secondary IMT (i.e. 9.8% lymphatic/medullary tumor, 9.8% infection, 5% liver disease, and 3% drug exposure). The sex tendency of IMT is at least twice as common in female as in male. Representative breeds include cocker spaniel, miniature poodle, toy poodle and Old English Shepherd. Genetic factors, combined with etiological triggers (e.g., environment, infection), have been theorized as potentially susceptible varieties, but more research is needed. Middle-aged dogs are most affected.

Clinical Signs
Some patients are asymptomatic. Most clinical symptoms occur with an increased tendency to bleed. Possible clinical symptoms include lethargy, anorexia, fever, weakness, petechiae, ecchymosis, pale mucous membranes, bleeding gums, blackness, hematemesis, blood in the stool, nosebleed, hematuria, hyphema, sclera or iris bleeding, retinal bleeding, blindness, frontal signs, altered mental status, epilepsy, lymphadenopathy, enlargement of the liver, enlargement of the spleen, lameness, cough, dyspnea, and hematoma formation.

Monitoring and prognosis
Reported that the platelet count in CBC should be monitored daily until platelets exceeded 50,000/µL. Then followed by weekly monitoring until platelet counts normalized. Within 7-10 days of starting glucocorticoids, the platelet count usually increases to 50-100,000 /µL. Immunosuppressive therapy can be tapered over 4-6 months once platelet counts return to normal. According to the general guideline,the standard is to reduce the dose by 20-25% every 2-3 weeks once the platelets are confirmed to be stable. Platelet counts were monitored every 1-2 weeks during the drug reduction period. One study reported that 16 primary IMT dogs received a median dose of prednisolone of 2.4 mg/kg/ day in remission and 0.9 mg/kg/ day in relapse. Prednisolone reduction rates were significantly higher in patients with acute recurrence (i.e., remission <60 days) compared to patients with delayed recurrence or no recurrence.If IMT is treated quickly and appropriately, the prognosis is usually good. Reported survival rates range from 70-90%. Relapse is possible (i.e. 9-58%), and some patients require long-term maintenance therapy. IMT can lead to death and is usually secondary to bleeding. Secondary infections caused by immunosuppression are also a concern. In a study of 73 dogs with primary IMT, 61/73 survived to discharge. The presence of melanoemia or elevated BUN on admission was associated with reduced survival. Another study of 30 dogs reported that 29/30 dogs survived at least 14 days after the onset of symptoms, with 27 dogs surviving 15-1684 days after the onset of symptoms (median 220 days). Another study of 46 dogs with primary IMT reported a survival to discharge rate of 73 percent, with an average hospital stay of 5.1 days. Of those who survived, 39 percent experienced a relapse. Treatment options include corticosteroids or glucocorticoids in combination with other drugs (e.g. Azathioprine, cyclosporine, vincristine). There is no significant difference between protocol and survival. Another study reported that patients with megakaryocyte thrombocytopenia had more severe anemia.The increased of clinical symptoms of bleeding.The number of transfusions required increased compared to dogs with primary peripheral IMT. In this study, 29 out of 34 primary IMTs survived to discharge, but only 1 out of 7 megakaryocytocytopenia survived to discharge.

The diagnosis and treatment of a canine infectious respiratory disease

Abstract

Canine infectious respiratory disease is called CIRD for short, which is a highly contagious disease in China,especially in the poor environment of the dogs houses and the dogs hospice. There are a number of dogs suffer from a coughing and recover quickly however,a bronchopneumonia can develop mild to severe. And CIRD is well-known considered to be a multi-factorial disease.In this case,patient perform coughing and sneezing,along with purulent secretion. As far as I am concerned,this disease is easily to be confused with the bacterial infection of respiratory for the pet owners,and it could be dangerous to the dogs especially of the young ages and the weakness. So it is important to know how to diagnose and therapy.
Key words: CIRD, diagnose, treatment, infectious.

1. Basic information

Name: LA LA
Breed: Labrador retriever dog
Sex: Female (no-castrated)
Age: 2 month old
Body weight: 5.2kg
History: no vaccination and deworming

2. Before therapy

The patient was bought from the dogs house 7 days before on Tiktok ,feeding in group in the dog house and performed normal at that time.Recently the owner found it coughing and sneezing but do nothing because of considering the changing of the environment.But 1 day before the symptoms of patient became worse and presented depressing and no appetite of food and water.According to the seller,there was a vaccination but only the first needle and no deworming history,feeding with young dogs food,and the other dogs had become similar symptoms these days.A stress, overcrowding, and increasing the length of stay in a shelter/kennel environment also helps the transmission of diseases.

3. Physical examination

This case was presented with a coughing and sneezing with yellow,purulent charge. The oral mucous membranes was pink and pale.Basic physiological of heart rate was 132 beats per mini,respiratory rate was 30 per min,temperature was 39.7℃,capillary refill time(crt)was normal(<1s).Cardiophony was no obvious abnormal while there was not clear sound in the auscultation of the chest.Bilateral ears,eyes were cleaned,and the purulent secretion was found in the nose.The surface of the skin was soft and a little dry with the membranes of the palmulas.Lymph gland palpation abnormal was not found except a mild swelling of the cervical lymph node.Inducing cough reflex testing was positive.No abnormal was found in the abdominal palpation and the bone palpation.

4. laboratory examination

4.1 Complete Blood Count(CBC)examination
Table 1 The result of the CBC examination

Project

Result

Reference Range

WBC

24.5

6-17×109/L

RBC

4.13

5.5-8.5×1012/L

HGB

9.2

8-15g/L

HCT

26.3

37-55%

MCV

63.7

39-55fL

MCH

22.3

12.5-17.5pg

MCHC

35

30-36g/L

PLT

284

300-800×109/L

LYM%

20.2

20-55%

OTHR%

82.7

60-77%

EO%

0.4

2-12%

LYM

1.6

1.5-4.8×109/L

OTHR

23.4

3-11.5×109/L

EOS

0.1

0.1-1.25×109/L

RDW

13

13-17%

PCT

0.18

0-2.9%

MPV

4.8

12-17fL

PDW

18.2

0-50%

4.2 The result of the CRP examination

Project

Result

Reference Range

CRP

10

<20mg/L

Complete Blood Count(CBC)examination: CBC examination showed a mild anemia in patient, but it may be a normal performance in the young dogs.The HCT,HGB and MCV was normal.In the part of white blood count index,we can see the rise of the white blood cells,as well as a right shift of the white blood cell nucleus in the microscope.The numbers of the lym cells are normal in the testing,is was weird in the virus infection patient and had a possibility that consumable with the causative agent.So,as i am concerned that it may suggesting the possible existence of infection and inflammation in this report.Thrombocytopenia may be associated with neutrophilia or the operation in blood collecting.
CRP examination: The result of the CRP was normal,this situation was not inconsistent with the CBC result which infer inflammatory.We know that the CRP is the fist inflammation index of dog,is the evidence of the acute inflammatory factor,can elevate highly in the acute injury and bacterial infection disease,so the normal number may not replace there was no inflammation in the body,it may be explained that the patient was in a chronic infection period.The result should analysis with the CBC and a following symptoms.

4.3The result of the 3 common infectious virus disease examination

Project

result

Reference Range

Cdv

0.22

<1 Coi

Cpv

0.32

<1 Coi

Ccv

9.51

<1 Coi

 

The result of antigen texting:Feces and secretion sample were collected to take a exam of the CDV,CPV and CCV antigen texting.We should know that this examination was convenient in the clinical but less accurate than PCR testing.So if the treatment response wasn’t accord with the doctor’s expecting,PCR may be taken for a better diagnosis.We can see that the CPV is positive in the report.

4.3 X-ray examination
The diagnosis and treatment of a canine infectious respiratory disease

Picture 1 Increased pulmonary markings in dog which infer the pneumonia – VD radiography
The diagnosis and treatment of a canine infectious respiratory disease
Picture 2 Increased pulmonary markings in the radiography in the chest – right lateral radiography

5. Diagnosis

Canine corona virus infection,Canine infectious respiratory disease

6.Treatment

(1)Prescription
①Lactated Ringer + 0.9% NaCl 1:1 (40mL/kg *24h)+ 1mL Vc, ivggt
②Cob 0.1mL, s.c
③IFN-w 250IU, s.c
④Cefotaxime sodium 250mg, s.c
⑤Doxorubicin 50mg, p.o
⑥Nebulizer therapy with 0.9% NaCl

The therapy continued for 3 day and in 4 day after the treatment,the symptoms of the patient became better,and it started to eat and drink.So stop giving liquid therapy and lessen the needle drugs.Only giving IFN and doxorubicin.Nebulizer therapy for every two days.After 7 days of the treatment,the symptoms of coughing and sneezing were less and less and rechecked the radiography of lung.We can see the abnormal area of the radiography was improved.Then the owner tooe it back home to nurse and kept on treatment of oral doxorubicin for 7days,during the days,adequate ventilation should be sure to helps reduce the spread of CIRD. The patient was recovery at last.

Picture 3 decreased pulmonary markings in dog compared with picture 1 – VD radiography
The diagnosis and treatment of a canine infectious respiratory disease

Picture 4 decreased pulmonary markings in the radiography in the chest – right lateral radiography

7. Conclusion

    Introduction:Canine infectious respiratory disease was describes as an acute infection primarily impacting the upper respiratory tract which is one of the most usual causes we have seen in the respiratory disease of dogs especially in the young ages.There are a several virus and bacteria are associal with canine infectious respiratory disease.In this case,the cause of the CIRD was diagnosed as canine respiratory coronavirus.There are a possibility that more than one viral may be affected the dogs such as canine distemper virus,canine parainfluenza virus,canine adeno virus type 2,canine influenza virus,canine herpes virus, canine pneumovirus amd canine reovirus.The other type of pathogens which is also common involved in dogs is the bacterial pathogens such as Bordetella bronchiseptica,Streptococcus equi subsp andMycoplasma spp.So it is important to differentiate diagnosis by a complete examination instead of giving drug empirically.And we may note that the healthy dogs can also harbor canine infectious respiratory disease pathogens in the clinically.Those dogs in group or not giving vaccination are more easily exposed to the pathogens.Canine infectious respiratory disease is transmitted by oral and nasal contact with aerosol form the respiratory secretions.The contaminated food and environment can also affect the patients.The incubation period is 2-3days usually and in some cases it may be up to 10 days which is depending on the virulence of the pathogen.
      The methods of diagnosis:In this case,we made a presumptive diagnosis of canine infectious respiratory disease according to the based clinical sings,life history and the physical examination.And taking a series of diagnostic examination in patients to confirm the result to avoid the risk that the patient did not respond to the supportive therapy and have a evidence to show to the pet owners.In some case,we can usually find the symptoms such as fever,lethargy,anorexia,coughing,snezzing,dehypration,edema conjunctiva,gagging,nasal and ocular discharge,retching,vomiting,tachypnea,trachea palpation painful,weakness and weight loss by doing physical examination.We have mentioned that several pathogens are associated with canine infectious respiratory disease,so we can not use the clinical signs alone to diagnose.
Complete Blood count:The changes of CBC testing are nonspecific in many times,but it can show us the situation in the body. We can see a stress leukogram or infection leukogram,with neutrophillia,lymphopenia and eoxinopenia in the testing usually.If the patient occur pneumonia,a left shift or marked leukocytosis can be found and it is a complicating factor in the disease.
Thoracic Radiography:Thoracic radiography examination are usually used in the patients of respiratory symptoms.Although it is unremarkable in some patients with uncomplicated canine infectious respiratory disease,this examination has a advantage of convenience and perceptual intuition.
ELISA of the antigen testing: antigen testings are one of the most commonly used tests and convenience methods for the viral detection in China.We can get the result in 30 minute and make a diagnosis quickly.But the False-negative and false-positive can occur with many reasons like improper sample collection and the quality of the viral testing kit.
Ploymerase Chain Reaction(PCR)assay:PCR assays are the one of the most commonly used tests methods especially in central hospital,which are a accurate and reliable methods.But it has some disadvantages like too long to get the result and it can be impacted by the improper sample collection.

    What is the treatment for CRID ? There are no specific anti-viral therapy for canine infectious respiratory disease if the affected pathogen is CcV.The principle of the treatment consists of supportive therapy according to the clinical sings to maintain the resistance to the infection .Antibiotic drugs are suggested to be used if there are sings and symptoms of secondary bacterial infection.Liquid therapy may be needed in the weakness dogs which do not eat and drink.Nebulizer therapy is a good choice to relieve the patients from injury of respiratory by the acute coughing.In most cases of CIRD whose signs are typically mild,antibiotic therapy may not be required in most times because they are self-limiting and can resolve spontaneously within 10 days.Hence,if the disease is due to viral infections,and the patients present secondary bacterial infection such as fever,lethargy,loss of appetite,along with a purulent nasal or ocular discharge, antibiotics are used although they are ineffective for the underlying cause.Doxorubicin is considered to be a good drug for a first choice to use because of its efficacy to against the common pathogens like Mycoplasma spp. And B.bronchiseptica,and has a good effect in respiratory tract.If lungs are involved in the infection, other broad-spectrum antibiotics like cefotaxime sodium may be needed.In ideally situation,we should select antibiotic drugs by the bacterial culture, but it is not reality in clinical therapy of sever patient.In some reports,the supportive therapy of prednisone may be considered as an anti-inflammatory drug to use to help relieve coughing.However,if the the level of the glucocorticoids are inhibited, there is a risk of infection. Besides,anti-tussives drugs like hydrocodone ,butorphanol and codeine may be used to reduce the frequency and intensity of coughing, however,coughing is also a protecting mechanism to increase clearance of respiratory pathogens for the patients,the suppressants of coughing can reduce this effects.So in this case, the anti-tussive s drugs should not be used in the patient because of the secondary bacterial infections.On the other hand,nebulization therapy is a good choice for solving the problem of excessive respiratory secretions.6-10mL 0.9% sterile NaCl liquid are beneficial.And the patient is suggested to be nebulized over 20 minutes q 12-24hrs.
Monitoring and Prognosis: In clinical ,most patients which is diagnosis as CIRD with mild symptoms can be treated and monitored as out patients and no need to stay in the hospital. Those that develop complicating factors such as this case which is pneumonia are require more intense monitoring and therapy.Vaccination is key to prevent the disease of infectious respiratory and can relief the symptoms although the vaccinated dogs still can be infected.In my experience,the prognosis is good in this king of patients and the clinical sings and symptoms are typically mild and self-limiting.But in the dogs which are not vaccinated,young ages or immunity suppressive,are at a higher risk for more severe symptoms and death rate. In this case,the therapy continues 14 day, and the symptoms are controlled.

The diagnosis and treatment of urinary disease

Abstract

The urinary system plays an vital role in excretion of the waste products and maintenance of electrolyte balance.The urinary disease can cause metabolic disturbances and derangements of fluid, electrolyte, and acid-base balance by any changing of pathology of the urinary system.It is too important to have a right diagnosis in the clinical.Radiography examination include Ultrasound (US) and X-ray are the most usually used clinical method for diagnostic urinary tract disease in dogs, as they are easy to perform to owners, inexpensive and provides excellent contrast resolution in clinical. Ultrasound is furthermore useful for guiding interventional procedures,which is more useful than X-ray some time.The urinary bladder is ideally suited for sonographic examination,we will also take urethral catheterization by it. In the urinary system It may have various differential diagnosis such as cystic neoplasm,cystic calculi and cystitis. Urinary tract infection is common in dogs especially in females,which is most often reporting the result of ascending fecal bacterial contamination of the vulva, perivulvar skin, vestibule.Treatment is easily to be taken under a right diagnosis and the prognosis can be depended on the ultrasonography which can judging the abnormalities of urinary bladder either in its wall or in the density of urine.

Key words: cystitis,cystoliths,diagnosis,

1.Basic information

Name: DA MA

Breed: Maltese

Sex: Female (castrated)

Age: 1.5 years old

Body weight: 14.7kg

History: regular vaccination and deworming on time

2. Before therapy

Upon initial presentation,the dog started to appear lethargic and weak.The pollakiuria and hematuria was noted in recent days.Regular vaccination and deworiming are giving on time,and eat commercial foods for DA MA.Without any changing with the symptoms,owners took her to the hospital.

3. Physical examination

The physical examination revealed a moderate distended and mild painful in the abdominal palpation.Heart rate was 110bpm.Respiratory rate was 30 per min.Temperature was 38.6℃.a prolonged(>2s)capillary refill time(CRT),and the presence of white foam on the tongue.It’s seemed to be no evidence of of foreign body in the abdomen.

4.Laboratory examination

4.1  Complete Blood Count(CBC)examination

Table 1  The result of the CBC examination

Project

Result

Reference Range

WBC

20

6-17×109/L

RBC

6.28

5.5-8.5×1012/L

HGB

145

120-180g/L

HCT

42.8

37-55%

MCV

66.7

66-77fL

MCH

21.5

19.9-24.5pg

MCHC

342

300360g/L

PLT

496

200-500×109/L

LYM%

6.0

1230%

OTHR%

82.5

60-77%

EO%

3.8

210%

LYM

1.9

1.5-4.8×109/L

OTHR

21.6

311.5×109/L

EOS

1.0

0.1-1.25×109/L

 

4.2 The result of the CRP examination

Project

Result

Reference Range

CRP

91.2

<20mg/L

CBC examination showed a obvious elevated of the white blood cells in patient,preliminary with the neutrophilic granulocyte.It may suggesting the highly possible existence of infection and inflammation.

The result of the CRP infer there was acute sever inflammation in the body,which was consistent with the result of CBC examination.

4.3  Idexx Catalyst biochemistry CHEM15

Table. 3  The result of the biochemistry CHEM15

Project

Result

Reference Range

GLU

5.31

3.89-7.95mmol/L

CREA

566

44-159umol/L

BUN

28.4

2.5-9.6mmol/L

BUN/CREA

5

 

PHOS

2.31

0.81-2.2mmol/L

CA

2.12

1.98-3mmol/L

TP

75

52-82g/L

ALB

28

22-39g/L

GLOB

45

25-45g/L

ALB/GLOB

0.62

 

ALT

233

10-125U/L

ALKP

200

23-212U/L

GGT

5

0-11U/L

TBIL

12

0-15umol/L

CHOL

6.13

2.84-8.26mmol/L

Biochemistry CHEM15 examination findings showed significant azotemia and hyperphosphorus, combined with physical examination and the symptom of the patient, suggested the possibility of urinary disease which was trigger by the pre or postreanl azotemia.Alanine transaminase was significantly increased,it may infer there was cells injury in the body.The result of ALKP,GGT and total bilirubin were not significantly increased.Cholesterol was normal.

4.4  X-ray examination

The diagnosis and treatment of urinary disease

Picture 1.Moderately to markedly radiopaque markings were found in the abdomen of patient.(VD radiograph)

The diagnosis and treatment of urinary disease

Picture 2. Moderately to markedly radiopaque markings were found in the abdomen of patient. – lateral radiograph

4.5、Ultrasonic examination

The diagnosis and treatment of urinary disease The diagnosis and treatment of urinary disease The diagnosis and treatment of urinary disease

Ultrasonic findings:

  • The bladder was fullin the examination, with the size of 3.37cm*1.41cm*2.43cm. The echo of the bladder wall was decreased with a low echo performance, thickness was about 0.19cm. There were high echo gritty suspended objects in the bladder, and several high echo liner with posterior acoustic.
  • The bilateralof kidneys outline wereclear, with a length of 2.62cm (left) and 2.67cm (right). The cortex showed moderate echo, the medulla showed low echo, and the cortical medulla was clearly demarcated. Doppler flow signal was distribution visibly in the image. No obvious dilatation was observed in renal pelvis and ureter.

Ultrasound diagnosis:

1.The decreasing of echo of bladder wall was indicating the cystitis;

2.High echoic suspension in the bladder, which were suspected of bladder crystallization;

3.Bladder stones (approximately at least three, the size of the largest one was about 1.31cm*0.85cm)

5.Diagnosis

Urolithiasis, cystitis

6.Treatment

6.1. Physical Urolith Removal

6.2. Antimicrobial Therapy:Ampicillin 25 mg/kg PO, IV, SC q12h

6.3. Calculolytic Diet Therapy:Hill’s Prescription Diet s/d.

In this case, the urinary obstruction did not happen.But it was necessary to remove the stones by surgical method to prevent urinary obstruction especially considering the size of stones (obstruction position can be found in renal pelvis, ureter, or urethra); when medical dissolution therapy fails; and for unacceptable clinical signs associated with urolithiasis.Antimicrobials are essential for treating infection-induced struvite uroliths.

Canine diets available for struvite dissolution include Purina Pro Plan Veterinary Diets UR Urinary St/O, and Royal Canin Veterinary Diet Urinary SO.Hill’s s/d is not intended for long-term maintenance nutrition. It must be used cautiously in young patients (i.e. because of reduced protein); in patients with hypertension and cardiac disease (i.e. because of increased sodium content); and in patients with history of pancreatitis (i.e. because of increased lipid content).Decreased BUN and albumin as well as increased ALP can occur in patients receiving Hill’s s/d.

After the physical removal,the patient was recovery and its urination was normal,but the diet therapy must be insisted at least 3 months and according the result of the symptom and urine examination.

7.Conclusion

Definition
Urolithiasis is one of a urinary disease which means one or more stones (uroliths) in the urinary tract. Uroliths can be found in the upper urinary tract (i.e. renal pelvis, ureter) and/or lower urinary tract (i.e. urinary bladder, urethra). Approximately 97% of uroliths occur in the lower urinary tract.

The most common of urolithiasis is struvite uroliths,which are composed of magnesium ammonium phosphate hexahydrate.Struvite uroliths occur most often in the urinary bladder and urethra, but they can occasionally be found in the upper urinary tract of dogs and rarely in cats.

Etiology and Pathophysiology
According to research, uroliths form with sustained alterations in urine which promote supersaturation of certain substances. Eventually, crystals form, which can become an organized stone.There is a Possibility that the factors involved in urolith formation consist of pH, mineral concentration of urine.Besides,inhibitors and promoters of urolith formation,complexors and macrocrystalline matrix are the factors too.Struvite uroliths can be infection-induced or sterile. In dogs,the most common form that inducing struvite urolithiasis is infection, whereas sterile struvite urolithiasis is more usual to be found in the cat.

Prevalence
According to various studies, struvite uroliths are currently either the most common urolith isolated from dogs or are a close second to calcium oxalate uroliths.Struvite uroliths accounted for 53.4% of canine uroliths submitted over a 19-year period in a report from the USA.Struvite uroliths accounted for 43% in a study from the UK and 32.9% in a study from Spain and Portugal.One study from Canada reported that 35.8% of all uroliths submitted from 1998-2014 were struvite uroliths.In a report from the Netherlands, struvite uroliths made up 40.9% of all submissions.Struvite uroliths accounted for 41% of all uroliths submitted from dogs to the Minnesota Urolith Center in 2007.Note that over time, incidence of canine struvite urolith submissions have declined, while calcium oxalate submissions have increased.Struvite uroliths accounted for approximately 75% of canine submissions in 1985.

Signalment
A Single struvite urolith is the most commonly diagnosed in young and adult dogs. They are also the most common type of urolith diagnosed in dogs <1 year of age.1 Struvite uroliths are more likely to form in female dogs than males. Approximately 71-85% of struvite uroliths submitted are from females.Small and toy breeds are more likely to be affected than large breed dogs.Breed predispositions include the cocker spaniel, miniature poodle, miniature schnauzer, shih tzu, lhasa apso, Pekingese, dachshund, and bichon frise.Some studies have also reported increased prevalence in the golden retriever, Labrador retriever, Bernese mountain dog, Saint Bernard, and rottweiler.Clinical Signs in some patients with struvite urolithiasis are asymptomatic. Hematuria, pollakiuria, stranguria, urinary incontinence, dysuria, vomiting, fever, dehydration, lethargy, depression, abdominal pain, vocalization, and/or collapse may be noted.

When to Suspect Struvite Stones

Bladder stones come in several mineral compositions. The most common stone types are oxalate and struvite.Because of the treatment is different for each type, it is crucial to determine the stone type. The stone type can be confirmed by stone analysis if a sample stone is available (either passed naturally or obtained via surgery). Laboratory analysis is a easily way to determine the content of the stone and even determine what the stone consists of. Without a sample stone, there are still some hints which can be obtained through other tests like microscope examination.As mentioned, struvite stones in dogs are almost always formed because of the nature of urinary changes occur with specific types of bladder infection: Staphylococcal is the first commonly infection bacterial but occasionally a Proteus infection. If a urine culture from a patient with a bladder stone should grow either staph or proteus, this would make struvite more likely than oxalate. Also, struvite requires an alkaline pH environment to form while oxalate requires form in an acid pH; urine pH is a key part of any urinalysis and thus provides another clue as to the stone’s identity.An well educated infer is better than nothing but does not replace the analysis of a stone. Do not forget that a stone of one type forms around a stone of another type occasionally . So a complete urinary or stone analysis is needed to effectively prevent recurrence.

The choice of the treatment

Struvite stones can be removed surgically with a technique called Cystotomy,and the other way is voiding urohydropropulsion in some cases; removed with a cystoscope (if they are small enough); or dissolved by diet. Stone dissolution with diet is the least invasive compared with the other ways and probably the best option unless the patients needs a faster treatment, considering if there is risk of urinary obstruction in a male dog in the future.

Dietary therapy is a medical treatment to prevent new struvite stones is of secondary importance in dogs (except the English Cocker spaniel, for which this is reported a hereditary metabolic problem rather than infection). The focus is on preventing infection. If the dog has a history of struvite bladder stones, we should discuss long-term monitoring to the owner and understand what schedule of testing is best for their dogs. During the time,we will expect periodic urine cultures.And emphasizing therapeutic diet must be the only food fed till the stone is completely dissolved. Antibiotic drugs are always needed as long as stones are in the bladder because of the existence of the bacteria in stones. Every 4 to 6 weeks, new radiographs should be taken to evaluate the stone size and if is at least 20 percent smaller than initial size, the process can be continued. A urinalysis is checked to be sure the proper urinary conditions for dissolution are being created by the dietary therapy.In the reported that the average are needed to dissolve the stone is 2 to 3 months, but the therapy should be continued for a month after the stones are no longer visible on the radiography examination since small stones may not be large enough to find.Microscope examination can be taken to check in this situation to have a more accurate result.If the infection has been controlled ,small stones can be dissolved in as short a time as a few weeks.

What should we pay attention after the treatment?

Many pet owner will focus on the recurrence of their patients.After stones are removed one way or another, the focus shifts to prevention. Usually the patients are predisposed to a bladder infection somehow, means they are also inclined to form more struvite bladder stones. A stone can form as quickly as two weeks after infection if a urease-positive bacterium sets in.After surgery, antibiotics must be continued until the infection is confirmed to have cleared (i.e. a negative urine culture is obtained). After this, a follow-up schedule of radiographs and/or urine testing is recommended. For a single stone episode in some dogs , only follow-up visits for many times may be necessary. Realize that some individual dogs are exactly predisposed to recurring infections in bladder and they may form new struvite stones again and again. Obviously, if the stones recur, a more regular monitoring schedule would have to be revised.Dietary therapy in the prevention of struvite stones is of secondary importance in dogs. The main focus is on preventing infection. If your dog has had a history of struvite bladder stones, make sure to discuss long-term monitoring and understand what testing schedule is best for your dog. Expect periodic urine cultures to be needed.

Diagnosis and treatment of canine diabetic ketoacidosis(DKA)

Abstract

Diabetic ketoacidosis (DKA) is a severe, life-threatening complication diabetes mellitus (DM) that is caused by an absolute or relative deficiency of insulin.A 13 years old dog (Name: Dumplings) with local purulent skin and infected ulcers on right hind limbs.Before coming to our hospital, he had been treated as a simple superficial dermatosis and bandage up the affected part for 4 days.The situation was worse during this days.In this case, we diagnosis as Diabetic ketoacidosis, and after the therapy, patient had gradually become stabilized.It was a big challenge to diagnose and treat in my clinical experience, and the cure rate depend on the condition of the therapeutic schedule and the body.

Key words

Diabetes: Diabetic ketoacidosis (DKA), diagnosis, purulent infection
day 5 master feeling dog never see symptoms improved, depressed and in spirit, appetite waste, hence to come to our hospital. After auxiliary examination, the dog was initially diagnosed as diabetic ketoacidosis (DKA). Subsequently, the dog was treated with fluid rehydration, anti-inflammatory and insulin, and the body condition gradually stabilized.

1.Basic information

Name: HUA HUA
Breed: Poodle
Sex: Female (castrated)
Age: 13 years old
Body weight: 4.7kg
History: regular vaccination and deworming on time

2.Before therapy

Owner took her to have a bathing 4 day ago.Puppy stylin found a ulcer on the skin of the right hind limb, which was purulent infection.So he see a veterinarian in the other animal hospital and the vet there treat as a simple trauma with surgical saline flushing.After 4 days of therapy, there was no changing of the symptom of the infected skin, and the patient started to be depression, losing appetite.So transferring to our hospital to have a further examination.

Diagnosis and treatment of canine diabetic ketoacidosis

3.Correlation examination

3.1 physical examination
Body weight 5.8kg, temperature 37.5℃, respiratory rate was 40/min.heart rate: 124 beats/min.mouth mucosa was pink, capillary refill time(CRT)>2s.body condition score(BCS)was 4/9. The patient was presented with depression.dry coat and nose. Abdominal palpation was found nervous and increased of abdomen.There were serve dental calculus and gingivitis in oral examination. A area of ulcer we can see on the skin of right hind limb, which was suppurative.
3.2 laboratory examination
3.2.1 Complete Blood Count(CBC)examination

Table 1 The result of the CBC examination(Day1)

Project

Result

Reference Range

WBC

10

6-17×109/L

RBC

3.68

5.5-8.5×1012/L

HGB

80

120-180g/L

HCT

23.8

37-55%

MCV

64.7

66-77fL

MCH

21.7

19.9-24.5pg

MCHC

336

300360g/L

PLT

543

200-500×109/L

LYM%

5.4

1230%

OTHR%

85.5

60-77%

EO%

8.8

210%

LYM

1.5

1.5-4.8×109/L

OTHR

23.9

311.5×109/L

EOS

2.5

0.1-1.25×109/L

3.2.2 Blood smear microscope under 100x

Diagnosis and treatment of canine diabetic ketoacidosis

Diagnosis and treatment of canine diabetic ketoacidosis

CBC examination showed a obvious anemia in patient, MCV decreased combined with blood smears microscope picture where were found different size of red bloods cells, we can have a preliminary judgement, it may be non-regenerative anemia in this report. To the white blood count index, we can see the rise of the white blood cells, as well as a right shift of the white blood cell nucleus in the microscope.It may suggesting the possible existence of infection and inflammation.Thrombocytopenia may be associated with neutrophilia and an underlying endocrine disorder.

3.2.3 Canine CRP examination
Table 2 The result of the CRP examination(Day1)

Project

Result

Reference Range

CRP

107.8

<20mg/L

The result of the CRP infer there was acute sever inflammation in the body, which was consistent with the result of CBC examination.

3.2.3 Idexx Catalyst biochemistry CHEM15
Table 3 The result of the biochemistry CHEM15(Day1)

Table 3  The result of the biochemistry CHEM15(Day1)

Project

Result

Reference Range

GLU

34.01

3.89-7.95mmol/L

CREA

775

44-159umol/L

BUN

34.4

2.5-9.6mmol/L

BUN/CREA

11

 

PHOS

4.35

0.81-2.2mmol/L

CA

2.30

1.98-3mmol/L

TP

78

52-82g/L

ALB

30

22-39g/L

GLOB

48

25-45g/L

ALB/GLOB

0.6

 

ALT

49

10-125U/L

ALKP

1963

23-212U/L

GGT

6

0-11U/L

TBIL

12

0-15umol/L

CHOL

10.13

2.84-8.26mmol/L

Biochemistry CHEM15 examination findings showed significant hyperglycemia, significant azotemia,and hyperphosphorus,combined with physical examination and the ratio of urea-nitrocreatinine, suggested the possibility of renal and prerenal azotemia. Alkaline phosphatase was significantly increased,but the result of GGT and total bilirubin were not significantly increased, cholesterol significantly increased,and there significant hyperglycemia at the same time, so it was suspected that it might be related to the steroid-induced increase of isoenzymes.

3.2.4 Electrolyte examination
Table 4 The result of the electrolyte examination

Project

Result

Reference Range

pH

7.108

7.25-7.40

pCO2

24.1

33-51mmHg

HCO3-act

7.5

13-25mmol/L

Na+

136

139-150mmol/L

K+

5.0

3.0-4.2mmol/L

Cl-

117

106-127mmol/L

AnGap

16

10-27

Osm

280

280-310mOsm/kg

Significant metabolic acidosis was observed in electrolytes examination. Mild hyponatremia and mild hyperkalemia may be associated with diabetes and kidney disease.
3.2.5 Blood pressure
The systolic blood pressure was 124mmHg as measured by a Doppler blood pressure monitor.
3.2.6 Diascopy and Fine needle aspiration examination

(A)Diagnosis and treatment of canine diabetic ketoacidosis

(B)Diagnosis and treatment of canine diabetic ketoacidosis

Picture 1. (A)A large number of degenerative neutrophils and several macrophages are seen.(B)and(A)The same slide sample, but with intracellular bacteria, suggests suppurative granulomatous inflammation caused by bacterial infection.

3.2.8 Urinalysis

Project

Result

Reference Range

Gravity

1.022

1.035-1.050

BLD

++

BIL

Neg.

UBG

Neg.

KET

++

GLU

++++

pH

5

6.0-7.0

In the urinalysis, we found the urine glucose and ketone were significantly increased, which means positive, the gravity of urine was lower than the reference range, and a large number of granular tubes were visible, suggesting diabetes, and there may be kidney injury or tubular disease. Mild occult blood.

4.Diagnosis

In conclusion with the consulting, clinical symptom,physical and laboratory examination, we have a preliminary diagnosis of diabetic ketoacidosis(DKA), and may concurrence with kidney and other endocrine disease.But the important thing was the treatment of DKA of patient now.

5.Treatment

The therapeutic goals of DKA animals are as follows:
1. Correct dehydration and electrolyte disorders:
(1) Replacement solution: Sodium lactate Ringer 250ml, ivgtt, 60ml/h: (If the concentration of sodium ion is >130mmol/L, sodium Ringer lactate should be used as the liquid; if the concentration of sodium ion is <130mmol/L, 0.9% normal saline should be used as the liquid)
(2) Maintenance solution: sodium lactate Ringer 360ml, ivgtt, 20ml/h: (Due to the electrolyte on the first day indicating mild hyperkalemia, no additional potassium chloride injection was added into the maintenance fluid, and further adjustment would be decided after the result of the electrolyte in the follow-up review. 1.5 to 2 times the amount of maintenance fluid is recommended in some cases)
(3) When the hydration status was corrected, the maintenance solution was continuously injected: sodium lactate Ringer 360-400ml+4ml10% potassium chloride injection, ivgtt, 20ml/h.
2. After 6h of the fluid therapy, adequate insulin was required to inhibit lipolysis, ketone body production, and the liver gluconeogenesis in the patient body.The dog was treated with the following insulin regimen: Insulin glargine (0.6U/kg/q12h) was injected subcutaneously, and blood glucose was monitored every 2h. When blood glucose was greater than 250mg/dL, short-acting insulin (0.1U/kg) was intramuscular injected, and hypoglycemia was monitored at the same time, with the goal of temporarily controlling blood glucose within 150-250mg/dL. Insulin treatment after stable blood glucose: 0.5-1U/kg, sc, q12h, blood glucose control below the renal threshold.
3.Correcting the acidosis of electrolyte: Sodium bicarbonate was not used to relieve acidosis in this case, and the current level of acidosis can be corrected by infusion and insulin. Blood gas results at 12h, 24h and 48h after treatment with fluid rehydration and insulin.

4.Treatment of complications:
(1) Improve renal perfusion through infusion and improve the situation of the azotemia;
(2) Using antibiotics to treat infection (abscess of the right leg) and control inflammation: amoxicillin clavulanate potassium, 18.5mg/kg, sc, qd.
(3)Painful management : Using analgesia, Butorphine, 0.2mg/kg, im, q8h;
(4)Provide iron-containing nutritional supplements to improve anemia;
(5)Provide carbohydrates (glucose) to allow continued insulin use without hypoglycemia.
Result of the case
On the third day after treatment, the acidosis of electrolyte was almost relieved. However, the elevated of the concentration of potassium ion in the dogs without adding more potassium chloride in the process of infusion, which may be suspected to be related to the co-existing kidney disease. And after 4 days of treatment, the patient had recover and go home.

6.Conclusion

Many dogs with DKA are presented as newly diagnosed diabetics.The mean age at diagnosis is 9-10 years of age.No sex or breed predisposition has been identified for DKA but they do exist for DM

Etiology and Pathophysiology

Insulin deficiency and increased levels of diabetogenic hormones (e.g. glucagon, cortisol, growth hormone, catecholamines) lead to abnormal glucose metabolism and hyperglycemia. In an insulin-deficient state, glucose transport into the cells is inadequate. Cells cannot use glucose for energy, which leads to cellular starvation. The body then starts to use adipose tissue as an alternate source of energy.Hormone-sensitive lipase is usually inhibited by insulin. With insulin deficiency, it facilitates the degradation of triglycerides and the formation of free fatty acids. Free fatty acids undergo beta oxidation within the cell to form acetyl-CoA. Acetyl-CoA accumulates in the liver where it is converted into acetoacetyl-CoA and ketone bodies, such as beta hydroxybutyrate, acetoacetate, and acetone.

The pathogenesis of DKA is not based on an insulin deficiency alone.An increase in diabetogenic hormones plays a significant role.Glucagon, growth hormone, and epinephrine stimulate lipolysis, thus increasing the amount of free fatty acids available for ketone formation.Glucagon and epinephrine also stimulate hepatic glycogenolysis and gluconeogenesis, as well as inhibit insulin-mediated glucose uptake by cells, which contributes to exacerbation of hyperglycemia.One study showed that 5/7 dogs with DKA had detectable endogenous insulin levels, and two of these dogs had insulin concentrations within the normal range. Therefore, other hormones are significant contributors to the development of DKA.

While the initial formation of ketone bodies serves as a protective mechanism against cellular starvation, eventually their utilization for energy is decreased due to limited cellular uptake. When ketone bodies continue to form and their utilization decreases, they start to accumulate.Ketone bodies are strong acids and their accumulation can quickly lead to metabolic acidosis. Ketonuria and osmotic diuresis from glucosuria leads to loss of sodium, potassium, and water in urine. These losses contribute to dehydration, hypovolemia, and further accumulation of ketones and glucose in the blood. Nausea, vomiting, and anorexia occur from stimulation of the chemoreceptor trigger zone by ketonemia and hyperglycemia, and contribute to the dehydration. Marked electrolyte abnormalities ensue.

Many patients with DKA are newly diagnosed diabetics. In one study, 65% (82/127) of dogs with DKA were diagnosed at the time of initial discovery of DM.Approximately 70% of dogs and 90% of cats with DKA have concurrent diseases. Some of the most common concurrent diseases noted in dogs include hyperadrenocorticism, pancreatitis, and bacterial urinary tract infections.

The choice of therapy

Treatment includes the specific therapy and supportive therapy.(1)Specific therapy:

Goals of therapy are to correct fluid deficits; correct electrolyte abnormalities; provide insulin; correct acidosis; and identify and treat underlying causes and concurrent diseases.(2)Supportive therapyConcurrent illnesses must be identified and treated appropriately. Antibiotics are indicated if a urinary tract or other bacterial infection is present. Antinausea medications are administered as needed for recurrent vomiting. Analgesics may be considered for dogs with pancreatitis.

Monitoring

Patients with DKA initially require hospitalization and intensive monitoring. Blood glucose levels are evaluated q 1-2 hours at first, then q 4-6 hours. Alternatively, a continuous glucose monitoring system can be used.It is important to frequently assess blood glucose to ensure that hyperglycemia is not resolving too rapidly. A sudden decrease in blood glucose can lead to rapid changes in osmolality with neurologic complications. It is also important to ensure that hypoglycemia does not develop.

Electrolytes are evaluated at least 1-2 times daily and more frequently in patients with significant derangements.Vital parameters (e.g. temperature, pulse rate and quality, respiratory rate and effort, hydration status, mentation, urine output, body weight) are also assessed multiple times daily to ensure fluid therapy is adequate.Urine or serum ketones can be evaluated at least once daily to assess response to therapy and resolution of ketonemia/ketonuria.

Prognosis

In one study of 127 dogs treated for DKA, 70% survived to be discharged from the hospital.5 Median hospitalization duration was 6 days.Non-survivors had lower ionized calcium, hematocrit, and venous pH compared to survivors.It is important to communicate with owners that therapy for DKA typically requires several days of hospitalization, and that a long-term commitment is also needed to treat DM once the animal is discharged from the hospital.

Canine coronavirus diagnosis and treatment

Abstract

Canine coronavirus (CCV) is divided into gastrointestinal type and respiratory type. Canine gastrointestinal coronavirus disease is a highly contagious infectious disease characterized by canine gastroenteritis caused by coronavirus. It is clinically characterized by acute vomiting, diarrhea and dehydration. Canine respiratory coronavirus is different from enteritis-type coronavirus. It is common in the early stage of canine infectious respiratory disease, mainly invading the upper respiratory tract and causing mild respiratory symptoms. It is prone to mixed infection with other respiratory pathogens clinically. Sick dogs and virus-carrying dogs are the main sources of infection, and the transmission channel is fecal-oral transmission. The mortality rate is less than 10%. Most of the deaths are due to young age or poor body condition and no active treatment. Dehydration and anorexia cause death.
In this article, canine enteritis-type coronavirus infection is mainly treated with active treatment and the prognosis is good. The cases are arranged as follows.

1:Case information

1. Name: Seven Seven
2. Variety: Pomeranian
3. Age: 1 year old
4. Gender: Female
5. Visiting time: 2022.10.2

2:Medical history investigation

1. Treatment problems: vomiting, diarrhea, lack of energy, loss of appetite
2. Chief Complaint: Vomiting for 4 days, 3 times a day on average, vomit from chyme to yellow liquid, diarrhea, watery feces started 2 days ago, usually eating dog food and omnivorous food (meat, snacks, rice, etc.), before the onset After taking a bath, I didn’t blow it dry in time. I bought it and raised it at home for 2 months. I took a vaccine and dewormed it once. The probiotics fed 2 days ago did not improve, and the symptoms worsened.

3:Physical examination

1. Overall inspection
BCS 3/9, lean body condition, prolonged capillary refill time, poor skin tone
2. General inspection
BW: 2.2KG, T: 40℃, HR: 90 times/min RR: 24 times/min, MM: pale
3. System check
Auscultation of the heart rhythm is uniform, no obvious heart murmur, mild abdominal pain on palpation, yellow vomit attached to the mouth, dirty around the anus, dry hair, dehydration assessment 6.
4. Laboratory tests
Check items: blood routine, acute inflammation, stool routine, CPV/CCV antigen test

Blood Routine

Project

Test Result

Reference Range

WBC

13.20×10^9/L

6-16.9

LYM#

1.5×10^9/L

1.1-6.3

GRA#

11.70×10^9/L

3.30-12.00

RBC

5.2×10^12/L

5.50-8.50

HGB

10.9g/dl

12.0-18.0

HCT

34.1%

37.0-55.0

MCHC

32.0g/dl

30.0-36.9

PLT

435K/μL

175-550

Acute inflammation

Project

Test Result

Reference Range

CRP

121.3mg/L

<20mg/L

Routine Stool Examination
1.Floating method: no parasite eggs are seen
2.Fecal smears: Bacillus+++ Coccus+++ Yeast+

Canine Coronavirus Diagnosis and Treatment

Canine Coronavirus Diagnosis and Treatment

CPV/CCV antigen detection

Project

Test Result

Reference Range

CPV

0.00

CCV

+

8.60

Blood routine anemia,acute inflammation moderate to severe acute inflammation,a large number of bacteria in stool routine,CCV positive in CCPV antigen test,the diagnosis direction is canine coronavirus infection.

4:Diagnosis and treatment

1.Diagnosis:
Anemia,severe acute inflammation of the intestine, positive for CCV, diagnosed as anemia, positive for canine coronavirus.
2.Treatment plan:
The dogs had relatively severe symptoms of vomiting diarrhea,delayed medical treatment, poor overall body condition,and the immunization program had not yet been completed. In the pre-hospital treatment, the correction of dehydration, antibacterial and anti-inflammatory,anti-viral symptomatic treatment should consider.
3.Treatment prescription:

Day One
1:LRS 60ML+0.6ML KCL IV
2:5%GS 50ML+50%GS 2ML+ATP0.2ML+COA1/4 IV
3:0.9%NS 50ML+Omeprazole 4mg IV
4:Cerenia 0.22ML SC
5:IFN 120IU BID SC
6:Enrofloxacin Injection 0.22ML SC
7:Butorphanol 0.22ML SC
On the first day of hospitalization, food and water were fasted, body temperature and body weight were measured on time, the frequency of vomiting and diarrhea, and the shape and texture of secretions were recorded.

Day Two
Symptoms improved, no vomiting and diarrhea, mental appetite has not recovered, no stool, urination
1:LRS 30ML+KCL 0.3ML IV
2:5%G 40ML+50%GS 2ML+ATP0.22ML+COA1/4 IV
3:0.9%NS 40ML+Omeprazole 4mg IV
4: Cerenia 0.22ML SC
5: IFN 120IU BID SC
6: Enrofloxacin Injection 0.22ML SC
7: Butorphanol 0.22ML SC
8: CATOSAL 0.22ML

Day Three
Symptoms improved, no vomiting and diarrhea, mental appetite recovered, no stool, urination
1:LRS 50ML
2:0.9%NS 40ML+Omeprazole 4mg IV
3:Cerenia 0.22ML SC
4:IFN 120IU BID SC
5:Enrofloxacin Injection 0.22ML SC
6:Butorphanol 0.22ML SC
7:CATOSAL 0.22ML
8:Probiotics PO
9:Intestinal prescription pot PO
10:Blood Supplementing Liver Essence Oral Liquid

Day Four
No vomiting after eating
1:Cerenia 0.22ML SC
2:IFN 120IU BID SC
3:Enrofloxacin Injection 0.22ML SC
4:CATOSAL 0.22ML SC
5:Probiotics PO
6:Intestinal prescription pot PO
7:Intestinal prescription food PO
8:Nourishing Liver Essence Oral Liquid

Day Five
Normal appetite and bowel movements, no vomiting
1:IFN 120IU BID SC
2:Enrofloxacin Injection 0.22ML SC
3:CATOSAL 0.22ML SC
4:Probiotics PO
5:Intestinal prescription pot PO
6:Intestinal prescription food PO
7:Nourishing Liver Essence Oral Liquid

4. The course of treatment
After five days of treatment, the dog was significantly improved, and the spirit and appetite were basically restored in the hospital, and the urine and urination also returned to normal.

Canine Coronavirus Diagnosis and Treatment

5 Treatment Precautions
All communicable diseases require the owner to be informed in advance of death and complications. In the early stage of treatment, the physical condition and dehydration of the animal should be assessed, and the acid-base balance should be corrected in time to avoid the animal being in a critical state. Watch out for complications during treatment. The dose of antibiotics used in young animals must be strictly controlled to avoid adverse effects on the growth and development of animals due to the toxic and side effects of the drugs.

5:Precautions

Canine coronavirus infection is still a relatively common infectious disease in dogs whose immunization procedures have not been completed. After discharge from the hospital, they are mainly fed with intestinal prescription food and intestinal prescription canned food, and combined with probiotics to regulate the gastrointestinal tract and hyperimmune factors to enhance the body Resistance, do not take a bath and do not go out to play during this period, pay attention to keep warm, observe whether there is a recurrence of mental appetite, bowel movements and vomiting after stopping the drug, and return to the doctor one week later.

6:Prognosis

The sick dog was re-examined one week later, and there was no recurrence of the dog. All indicators were normal, and the coronavirus had recovered. In the later stage, it was necessary to complete the immunization program, deworm on time,and do good job in preventive management. Canine coronaviruses generally have a good prognosis with aggressive treatment.

7:Disease pathogenesis and prevention

After oral exposure to susceptible dog 2, the virus reaches the upper duodenum and mainly affects the digestion and absorption cells in 2/3 of the villi of the small intestine. The virus enters the enterocytes between the microvilli by pinocytosis, and is located in the cytoplasmic vacuoles. Buds on smooth membrane. Due to the rupture of the cell membrane, the virus enters the intestinal lumen with the shed infected cells, and then infects the villous epithelial cells of the entire intestinal segment of the small intestine, resulting in short and thick villi, loss of digestive enzymes and intestinal absorption, and vomiting. diarrhea. Subsequently, with the recovery of the structure of the small intestine, the clinical symptoms disappeared, the detoxification was reduced and terminated, and neutralizing antibodies were produced in the serum. At present, there are vaccines that can prevent canine coronavirus. When vaccinating dogs, it is recommended that pet owners choose infectious disease vaccines that are relatively comprehensive to prevent diseases. susceptible animals.

A canine distemper infection diagnosis and treatment report

Abstract

Infected by canine distemper virus (CDV), canine distemper is a highly contagious infectious disease that can affect not only canines but also a variety of wild animals such as raccoons, skunks, foxes, ferrets and big cats animals (such as lions). Symptoms of canine distemper infection are the respiratory, gastrointestinal, urothelial, central nervous system, and optic nerves. The disease is common in areas with low vaccine coverage, so it can occur globally. In this case, the dog has respiratory symptoms, and I’ll talk about how to diagnose and treat canine distemper infection to give you a better understanding of the disease.

Key words: canine distemper infection, diagnosis, pneumonia.

1.Before therapy

Name: WangWang
Breeds: Border Collie
Age: 4 months old
Sex: Male(no castrate)
History: No

Main problem by the owner
The dog was bought from a kennel and the director fed it at home for two weeks. The owner found it coughed, sneezed, and had a runny nose yesterday, then became depressed, lost appetite, and had diarrhea. This is the first time the owner has fed the dog, and there is no other dog history. The dog has no complete vaccination history (the first dose of Vanguard® Plus 5 was given a month ago) and no deworming history.

2 .Physical examination

The patient in this case was depressed, with pale and dry oral mucosa, arrhythmia, rapid breathing, and a large amount of purulent secretions. The basic physiological body temperature was 39.9°C, the inferred hyperthermia, the heart rate was 120 beats/min, and the respiratory rate was 20 beats per minute. Capillary refill time (CRT) normal (<2s), with a body weight of 2 kg and a moisture assessment of 8%. A small amount of discharge was found in both ears. Lymph nodes were palpated without significant swelling or pain. Induce a positive cough reflex. There was no obvious abdominal response to abdominal palpation. 

A canine distemper infection diagnosis and treatment report

3.Laboratory examination

3.1 completed blood count(CBC)

Form 1 Complete Blood Count(CBC)result【BC-2600Vet(Mindray)】

Project

Result

Reference range

WBC

6.8×103/uL

6.0~17.0

Lymph#

2.4×103/uL

0.8~5.1

Mon#

0.3×103/uL

0.0~1.8

Gran#

4.1×103/uL

4.0~12.6

Lymph%

35.2%

12.0~30.0

Mon%

4.7%

2.0~9.0

Gran%

60.1%

60.0~83.0

RBC

5.43×1012/uL

5.5~8.5

HGB

109g/L

110~190

HCT

36.7%

39.0~56.0

MCV

64.6fL

62.0~72.0

MCH

20pg

20.0~25.0

MCHC

197g/L

300~380

RDW

13.1%

11.0~15.5

PLT

836×109/uL

117~460

MPV

8fL

7.0~12.9

PDW

18.1

 

PCT

0.668%

 

Eos%

1.9%

 

3.2 CRP test

The resulT of CRP testing【AnigenV2000】

Project

Result

Reference Range

CRP

36.61mg/L

<0.5

3.3 Infectious disease sample testing

Examination for infectious diseases【AnigenV2000】

Project

Result

Reference Range

CDV-AG

52.6

<1

CIV-AG

0.3

<1

3.4 X-ray examination

A canine distemper infection diagnosis and treatment report

 

 

Picture 1 Increased bronchial markings in dog with bronchitis – VD radiograph

Picture 2 Increased bronchial markings in dog with allergic bronchitis – lateral radiograph

A canine distemper infection diagnosis and treatment report

4.Diagnosis: canine distemper infection

4.1 Here are the Introduction of the diagnosis methods

Complete blood count: Severe leukopenia is common. Other potential findings include anemia, thrombocytopenia, mononucleosis, and neutropenia.
Biochemical profile: results are normal or variable.Hyperphosphatemia, hypoalbuminemia, and hypoalbuminemia have been reported.
Serology: Antibody titer tests can indicate the presence or absence of protective levels of antibodies against CDV, and in-house test kits are available and reliable. 15,17 Antibody testing helps determine the protection status of previously vaccinated dogs, where vaccination may pose a risk, and helps determine immunity in dogs entering shelters. Please note that for 17 antibody tests, negative titers do not indicate sensitivity. Some immunized dogs may have undetectable antibody levels but are able to mount an appropriate response when exposed to CDV. Internal testing may not accurately distinguish between maternal immunity and innate immunity in 4-6 month old dogs, but 17 IgM levels can be detected in acute cases of canine distemper. It may be present for up to 3 weeks after vaccination with CDV. IgG titers are nonspecific. Elevated IgG titers may indicate current infection, previous infection, or previous vaccination.
Cytology: CDV cytoplasmic and intranuclear inclusions are occasionally found in cells on stained peripheral blood smears or conjunctival swabs/scraps. Inclusion bodies are single, oval, gray bodies up to 3 µm in diameter. Inclusion bodies are more common in lymphocytes and epithelial cells, less common in neutrophils, monocytes, eosinophils and red blood cells. The erythrocyte inclusion bodies are eccentric, round and light blue.
Radiography: Alveolar or interstitial patterns are common in chest radiographs of dogs with pneumonia. Radiographic changes consistent with hypertrophic osteodystrophy may also be noted.
Cerebrospinal fluid (CSF) analysis: In the setting of acute, non-inflammatory encephalomyelitis, CSF analysis may be normal. In chronic CDV encephalomyelitis, elevated protein levels (>25 mg/dL) and cell counts (>10 cells/µL, mainly lymphocytes) are possible and inclusion bodies can be found in the cells. CDV antibody levels can be measured in CSF. Antibody levels in the CSF were not increased in vaccinated dogs or in dogs with systemic disease without CNS infection. However, antibody levels may increase secondary to blood contamination during CSF collection.
Autopsy: Possible pathological changes include diffuse interstitial pneumonia, enteritis, conjunctivitis, rhinitis, thymic atrophy, poliomyelitis, leukoencephalomyelitis, demyelination, neuronal degeneration, and myelin degeneration.
Virus isolation: CDV is difficult to isolate from conventional cell cultures.
Polymerase chain reaction (PCR) testing: PCR testing is a highly specific method for diagnosing CDV. PCR testing can be performed on whole blood, conjunctival swabs, buffy coat smears, and urine sediment. Using a cutoff of 107903 viral particles can help real-time PCR differentiate vaccine interference from wild-type infection. PCR assays are 30% more sensitive than immunofluorescent antibody (IFA) assays in diagnosing CDV.
IFA test: IFA tests can be performed on the conjunctiva, tonsils, respiratory tract, and genital epithelium. Antigens can also be detected in urine sediment and buffy coat samples. Note that immunofluorescence is usually only positive for the first 3 weeks after infection in conjunctival and urothelial samples. Buffy coat samples are usually positive 2-5 days after infection, after which antigen levels begin to decline 8-9 days after infection. CDV persists for at least 60 days in uveal tissue, CNS tissue, skin samples, and footpads.
Immunochromatography: Conjunctival swabs have been subjected to immunochromatography using two anti-CDV antibodies. This assay has higher sensitivity and specificity compared to nested PCR assays. Results from nasal swabs and peripheral blood lymphocyte samples were less sensitive and specific than PCR assays.
Other tests: Virus neutralization and hemagglutination inhibition are the gold standards for accurate detection of CDV antibody protection levels.

4.2 Analysis of this case

In this case, the differential diagnosis was based on clinical signs, physical examination and laboratory tests, including viral infectious diseases (such as CDV or CIV), bacterial infectious diseases and some parasitic diseases. Complete blood count (CBC) and CRP tests showed acute to moderate inflammation. The X-ray and lateral films of VD inferred that the inflammation was caused by bronchitis, which is one of the typical symptoms of canine distemper infection. In addition, the vaccine history in this case is not of our concern, the dogs tested for CDV and CIV infection, and the CDV test was positive and CIV negative. Therefore, we initially diagnosed that the dog was infected with canine distemper. In addition canine distemper is sometimes associated with other systemic infections (eg, leptospirosis, canine hepatitis, rabies, canine respiratory disease, Rocky Mountain spotted fever). So PCR is an important tool to help us make an accurate diagnosis.

A canine distemper infection diagnosis and treatment report

5.Treatment

5.1 SPECIFIC THERAPY

There is currently no specific therapy for CDV, and management is primarily supportive. Ribavirin, an antiviral drug that inhibits CDV replication in vitro, has not been thoroughly evaluated in infected dogs. This requires further research.

5.2 SUPPORTIVE THERAPY

Fluid therapy (IV, SC) may be required to correct dehydration and replace ongoing losses. Coupage and nebulization may be beneficial for bronchopneumonia. CDV pneumonia is often complicated by secondary bacterial infection and may also require treatment with broad-spectrum antibiotics. Antibiotic therapy may be required for several weeks, or as a combination therapy. Antiemetic therapy is indicated for patients with vomiting. Dexamethasone can be administered once intravenously at a dose of 1-2 mg/kg to temporarily stop neurological signs associated with cerebral edema. Anticonvulsant therapy is indicated for seizures. Diazepam (5-10 mg IV or rectally) and other drugs can be used to treat status epilepticus. Phenobarbital (10-20 mg/kg IV once effective, then 2-8 mg/kg PO q 12 hours) or other anticonvulsants can be used for acute and maintenance therapy.

RX:
1) Ampicillin: 20 mg/kg PO, IV, SC q8h
2) Interferon: 100IU/kg s.c q24h
3) Anti-CDV protein: 100IU/kg s.c q24h
4) Lactated Ringer + 0.9%NaCl 1:1:60mg/kg/d ivgtt
After 1 week of treatment, the dog’s symptoms were controlled. After 3 weeks of treatment, the dog recovered and the owner took him home.

6.Conclusion

Most of us have heard of canine distemper infection in dogs and thought it was bad. The basic vaccine for dogs is often referred to as the “canine distemper vaccine,” although it also covers several infections in addition to canine distemper. Fortunately, this is the canine distemper that most people have heard of. Thankfully, first-hand experience of this dreaded disease has become limited due to widespread vaccination. However, if you are reading this, you may have a dog suspected of having this dreaded infection. A typical canine distemper suspect is a rescue or pet store dog or puppy, often with a suspicious vaccination history or an uncompleted vaccination series. Dogs or puppies are housed with other rescue dogs or a group of dogs/puppies that are transported together. Symptoms begin with:
Respiratory signs are more common, and mild canine distemper may present with lethargy, decreased appetite, fever, cough, dyspnea, and serous to mucopurulent nasal discharge. Fever can appear 3-6 days after infection, with a second peak a few days later. More severe clinical illness usually occurs in immunocompromised puppies. Fever, runny nose, serous to mucopurulent conjunctivitis cough, dyspnea, vomiting, diarrhea, tenesmus, weight loss, and dehydration may occur. Secondary bacterial infection can worsen the clinical presentation. Neurologic manifestations may appear 1-3 weeks after systemic disease or may occur concurrently with systemic disease. Neurological signs may be acute or chronic and are usually progressive. Possible clinical abnormalities include hyperesthesia, cervical stiffness, vestibular signs, seizures, ataxia, cerebellar signs, paraparesis, tetraparesis, and myoclonus (ie, involuntary rhythmic muscle twitching). Ophthalmic and dermatological findings may also be reported.
Diagnosis and treatment have been covered before, so here I will emphasize monitoring and prognosis to the reader. Antibody titer testing can be used to determine whether enough circulating antibodies are present to prevent CDV infection. Prognosis depends on the virus strain and the immune response of the host. 3 Nervous system signaling is the most important factor affecting prognosis. The prognosis for dogs with neurological signs is considered poor. The reported mortality rate is about 50%. Older dogs with an adequate immune response may be asymptomatic or mildly diseased. Puppies or puppies with an insufficient immune response tend to develop more severe disease. Dogs recovering from CDV may be long-term immune to reinfection and may be immune for life.
Finally, I’ll talk about how to prevent it. Control is accomplished through vaccination. Current vaccines include strains of American ancestry (Onderstepoort or Lederle strains). Immunity can last for years after recovery from a natural infection or after a booster vaccination. CDV vaccination can start as early as 6-8 weeks of age with booster immunizations every 2-4 weeks until at least 16 weeks of age. In puppies or adult puppies vaccinated after maternal immunity has weakened (approximately 16 weeks of age), a single live or recombinant vaccine should be sufficient for protection. In vaccinated older dogs, canine distemper vaccination is recommended annually or every three years, depending on the risk of infection. Customer education about purchasing puppies from crowded pet markets is important. CDVs are susceptible to UV light, heat, drying and all commonly used disinfectants. No vaccine is 100% effective, but regular vaccinations can help protect animals.

A diagnostic and treatment of canine acute pancreatitis

Abstract

Pancreatitis is an inflammation of the pancreas. A female,pomeranian dog was presentd with sign of depression and vomiting of 3 days duration following episode of dietary indiscretion.Clinical signs,previous medical history, and diagnostic test supported diagnosis acute pancreatitis. Specific and supportive treatment was instituted,and clinical signs resolved 3 days after presentation.
Key words:Vomiting,Pain management,shock

1. Bases information

A diagnostic and treatment of canine acute pancreatitis

Name: BAI BAI
Breed: Pomeranian dog
Sex: Female (castrated)
Age: 3 years old
Body weight: 3.7kg
History: Dietary habit with meat and mankind food for a long tern

2. Before therapy

A diagnostic and treatment of canine acute pancreatitis

At the first visit, the dog began to show symptoms of lethargy and weakness, especially weakness in the pelvis and limbs, and would not fall over after walking more than a few steps. The owner noticed it was vomiting and it has gotten worse recently. The day before the examination, Bai Bai had no appetite at all and took her to the hospital. Completed a vaccine history check and found it was not dewormed this year.

3. Physical examination

On physical examination, it showed increased mouth-breathing, forceful injection, and injection into the oral mucosa. The surface was cold when the limbs were in contact, and the oral mucosa was injected at the same time, the capillary refill time (CRT) was prolonged (>2s), and white foam appeared on the tongue. Tachycardia (heart rate 170 beats/min) and mild hypothermia (37.2°C). The abdomen was slightly distended and painful on palpation, and upon examination, there appeared to be no evidence of a foreign body.

4. Laboratory examination

4.1 Complete Blood Count(CBC)result

Project

Unit

Result

Reference Range

RBC(Red blood count)

109/ L

7.35

5.65~8.87

HCT

 

0.411

0.37~0.55

HGB

109/ L

136

120~180

MCV

fL

55.9

61.6~73.5

MCH

pg

18.5

21.2~25.9

MCHC

g/L

331

320~360

WBC(Whiteblood count)

109/ L

14.9

6~17

LYM

%

0.083

0.6~0.77

EOS

%

0.01

0.06~1.23

OTHR

%

0.93

0.6~0.77

PLT

109/ L

45

200~500

4.2 Idexx Catalyst biochemistry CHEM15

Project

Unit

Result

Reference Range

GLU(Glucose)

mmol/L

7.5

4.11~7.95

CREA(Creatinine)

mg/dL

65

44~159

BUN/CREA

 

2.1

 

TP(Total protein)

g/L

71

52~82

ALB(ALBUMIN)

g/L

22

23~40

GLOB(Globulin)

g/L

49

25~45

ALB/GLOB

 

0.45

 

ALT(Alanine transaminase)

U/L

49

10~125

ALKP(Alkaline phosphatase)

U/L

11

23~212

GGT

U/L

0

0~11

TBIL

umol/L

1

0~15

CHOL

mmol/L

1.44 

2.84~8.26

PHOS

mmol/L

0.57 

0.81~2.20

Ca

mmol/L

2.05

1.98~3.00

AMYL

U/L

554

500~1500

LIPA

U/L

441

200~1800

4.3 EDXX cPL test

Project

Result

CPL

Positive(+)

4.4 CRP test

Project

Result

Reference Range

CRP

39.78  mg/L

≤20

4.5 X-ray examination

A diagnostic and treatment of canine acute pancreatitis                  A diagnostic and treatment of canine acute pancreatitis

Picture 1-2:Gas accumulate in abdomen seen on radiographs from a dog. Ultrasound showed pancreatitis.

A diagnostic and treatment of canine acute pancreatitis

Picture 3 :In this image we can see the enlarged pancreas with hypoechoic and hypoechoic areas within it.

Diagnosis: Acute pancreatitis

Differential diagnosis based on clinical symptoms, physical examination: acute pancreatitis, foreign body or toxin ingestion. Liver or kidney disease cannot be ignored. Gastric dilatation torsion (GDV) is found in animals in pain, leptospirosis is usually found, and initial diagnostic tests include abdominal X-ray, complete blood (cell) count (CBC), complete biochemical profile, and canine pancreatic lipase SNAP test (Canine SNAP cPL; IDEXX Laboratories, Westbrook, Maine, USA). There was no obvious foreign body in the abdominal dorsal and right abdominal X-ray films except for abdominal gas, which may cause vomiting and blood circulation disorders due to pain. CBC, CRP, and biochemical studies show a Acute inflammation;Hypoglobulinemia; Hypophosphatemia; and e Hypochloremia. Canine SNAP cPL test was positive. The numerical results of these experiments are summarized in Tables 1-2.
The blood smear showed no toxic changes, and the CRP results were presumed to be inflammation. Decreased albumin presumably may be due to nutritional deficiencies and their manifestations were found.Hypochloremia and hypophosphatemia are most likely due to loss of chloride and phosphorus in vomit. In many cases acute pancreatitis we see hypercholesterolemia, but it is normal in this case. The Canine SNAP cPL test returned a positive result, and a combination of the dog’s medical history, physical examination, radiology results, and blood and biochemical features led to an initial diagnosis of acute pancreatitis.

Treatment

Rx:
1. Lactated Ringer + CoB ivggt
2. 0.9% Nacl + Omeprazole ivggt,bid
3. Maropitant s.c sid
4. Lidocanine CRI for 24h
Initial supportive treatments consisted of Lactated Ringer(crystalloid intravenous fluids)at a rate of 300mL/h for 3h to supply the dehydration, lidocanine CRI at a rate of 0.05mg/kg/h for 24h, and provide warm-water bag to recovery the temperature.After 6 hour, the dog could wake up by himself. And we treated with Synulox(amoxicillin clavulanic acidt), 20mg/kg,IV, q24h to prevent the secondary to bacteria infection from the damaged pancreas, omeprazole ,1mg/kg, mixed with 30mL 0.9% NaCl liquid, IVGTT in 30min q12h, Maropitant at 1mg/kg s.c q24h as an antiemetic therapy. When the dehydration was no longer clinically detectable, the LRS fluid rate was reduced to 50mL/h.

A diagnostic and treatment of canine acute pancreatitis

24 hours after the dog was sent to the hospital, he was more alert, his body temperature, breathing, and pain began to stabilize. He did not vomit after being admitted to the hospital, and he could drink a small amount of water. This time, the treatment with canned rice powder lasted for 2 days. The dog can walk and control the pace without collapsing, indicating that the weakness of the pelvis and limbs has recovered. Instruct the owner to feed the dog a tablespoon amount, and offer a small meal if the dog does not vomit. After 5 days of cessation of antiemetic treatment, the clinical symptoms did not reappear and the client requested to bring the dog back.

Summary

Pathophysiology of Pancreatitis

Pancreatitis is inflammation of the pancreas, which can be acute or chronic.
The major digestive enzymes are present in pancreatic acinar cells in an inactive form called zymogens. Packaging inactive enzymes into proenzymes helps prevent premature activation prior to release into the duodenum. 9 Enzyme inhibitors are also present in the pancreas (eg, alpha-antitrypsin) and circulate in plasma (eg, alpha-macroglobulin, antichymotrypsin, alpha-antitrypsin). Once zymogens are released into the intestinal lumen, they are broken down by enterokinase peptides secreted by duodenal mucosal cells. This breakdown activates pancreatic enzymes and allows them to begin digesting nutrients. If the inhibitory substances are blocked, or the enzymes are activated while they are still in the pancreas, the pancreas begins to digest itself inappropriately. For example, the conversion of trypsinogen (inactive) to trypsin (active form) can be triggered by enterokinase, bile, lysosomal enzymes, or other stimuli. The result is pancreatic membrane destruction, dilation of arterioles, increased vascular permeability, edema, and hemorrhage, followed by pain, leukocyte infiltration, and peripancreatic fat necrosis. Decreased blood flow to the pancreas and leukocyte infiltration can lead to pancreatic necrosis. Secondary infection may be due to arterial hypotension, portal hydrops, and hypovolemia that may lead to shock.
Peripheral venous constriction and leakage of pancreatic enzymes into the abdominal cavity and vascular compartment exacerbate the injury. Local tissue invasion and destruction caused by pancreatic enzyme release can be extensive. Possible end results include damage to the liver, kidneys, lungs, heart, and abdominal lymphatic vessels. Pancreatitis can lead to obstruction of the extrahepatic bile ducts. The feline pancreas is also prone to ascending biliary infection and bile reflux because the pancreas and bile ducts merge with the papilla before reaching the duodenum.

Types of Pancreatitis

Pancreatitis in dogs can be classified as acute or chronic. Acute pancreatitis is characterized by neutrophil infiltration, moderate to severe pancreatic necrosis, edema, and/or hemorrhage. Acinar tissue and ducts remain intact. Chronic pancreatitis is a long-term inflammation associated with low-grade, mononuclear inflammation and fibrosis. Chronic pancreatitis may be a sequela of recurrent acute pancreatitis. Chronic pancreatitis can eventually lead to diabetes and/or pancreatic exocrine insufficiency. There is no clinical distinction between acute pancreatitis and chronic pancreatitis. Although acute and chronic cases may have mild or severe clinical symptoms, chronic cases are more likely to have mild symptoms, while acute cases usually have severe symptoms.

A diagnostic and treatment of canine acute pancreatitis

Etiology and Risk Factors of acute pancreatitis

The cause of acute pancreatitis is usually unknown. Risk factors associated with fatal acute pancreatitis include being overweight, so we’ll discuss some nutritional therapy later; the presence of diabetes, hyperadrenocorticism, hypothyroidism, or epilepsy; and pre-existing gastrointestinal (GI) tract disease history. A study suggests that increasing age and certain breed types are risk factors for pancreatitis. 11 Breeds with a reported higher risk of pancreatitis include Miniature Schnauzers, Dachshunds, Miniature Poodles, Cavalier King Charles Spaniels, Cocker Spaniels, Collies, Boxers, as well as Yorkshire Terriers, Foxes and others. Terrier. In one study, neutered females and castrated males had an increased risk compared with males who did not have sex. Affected dogs are mostly middle-aged dogs. In one study, eating unusual or human foods was shown to increase the chance of developing pancreatitis, similar to this case. Other potential risk factors include high-fat diet, malnutrition, hypertriglyceridemia, exposure toxins(eg,zinc,organophosphates), hypercalcemia, pancreatic duct obstruction, and reflux of duodenal contents into the pancreas. ducts, pancreatic trauma (eg,surgery,blunt instruments), parasites(eg, flukes), hepatobiliary disease, small bowel disease, and pancreatic ischemia/reperfusion injury. Infection with Babesia rosei has been associated with pancreatitis, however, Babesia gibbetii infection is less likely to cause pancreatitis.

Nutritional Therapy

An important risk of acute pancreatitis is being overweight, so we will discuss nutritional management of the pancreas in this section. Traditionally, fasting is done for the first 24-48 hours, as food stimulates the pancreas. However, there is currently debate over when to feed affected dogs. Prolonged fasting can lead to hypoalbuminemia; loss of intestinal motility; increased intestinal permeability; decreased intestinal blood flow; Feed small amounts. One study showed that dogs fed within 48 hours of hospitalization had reduced time intake to resume voluntary food intake and maximal food intake, as well as fewer gastrointestinal symptoms. The length of hospital stay was not affected. Enteral nutrition is preferred over parenteral nutrition in patients with acute pancreatitis.
The ideal diet for dogs with pancreatitis is unclear. However, feeding an easily digestible, low-fat diet is usually the initial choice. A diet of ≤8% fat on a dry matter basis is generally recommended. Diets designed for obesity management or fibro-responsive disease are less digestible and may not be suitable. Once recovered, some patients need to be on a high-digestive, fat-restricted diet long-term, especially those at risk of relapse or with hyperlipidemia. Other patients may be able to transition to a moderate-fat diet, i.e. up to 15% fat on a dry matter basis.

Monitoring and prognosis

Patients with acute pancreatitis may have mild to severe clinical symptoms. On the other hand, patients with chronic pancreatitis tend to have mild intermittent signs. Vomiting occurs in approximately 90% of dogs with pancreatitis and abdominal pain in 58%. Other possible signs include lethargy, anorexia, diarrhea, cranio-abdominal pain, irritability, blood in the stool, and hematemesis. Severe acute pancreatitis may present with fever, collapse, and vomiting. Evidence of concurrent coagulopathy (eg, petechiae), hepatobiliary disease (eg, jaundice), diabetes (eg, polyuria, polydipsia), and AKI (eg, oliguria) may be present. 9,62 Diabetes mellitus is the most common co-morbidity.
Monitoring requirements vary depending on the severity of pancreatitis and the presence of other systemic abnormalities. Vital parameters, body weight, pain scores, and fluid intake and output were assessed multiple times daily in hospitalized patients. Some tests, such as CBC, biochemical tests, electrolytes, blood pressure, and coagulation status, require repeated evaluation. Monitoring of clinical improvement in patients treated in outpatient setting. Repeat cPLI, ultrasonography, and CRP testing can be done to determine if pancreatic inflammation is receding.
Patients with mild acute pancreatitis usually have a good prognosis. The prognosis for patients with severe acute pancreatitis is more cautious. Patients with chronic pancreatitis may eventually develop pancreatic exocrine insufficiency. In a study of 138 dogs with acute pancreatitis, 33% died within 30 days of diagnosis. Bilirubin concentrations ≥18.7 mg/L, elevated creatinine, hypocalcemia, metabolic acidosis, and AKI grade 4 or 5 in IRIS were associated with increased short-term mortality. In a study of 50 dogs with acute pancreatitis, serum sodium <139 mmol/L was associated with poor prognosis. In another study, high ALT at diagnosis was associated with longer hospital stay, and lower CRP levels were associated with recovery.

A diagnostic and treatment of canine acute pancreatitis

A case of canine babesiosis infection report

Abstract

Canine babesiosis is a kind of blood protozoa disease which transmitted by ticks. It is caused by a group of intraerythrocytic (piroplasm), hemo-protozoan organisms of the Apicomplexa phylum.Babesia spp. are classified into large and small forms. Dogs and cats may be infected with either form, although infection in cats is rarer than in dogs.Babesia spp. are the second most common hematologic parasite of mammals worldwide.Symptoms such as depression, shortness of breath, fever, loss of appetite, anemia, brown or red urine, yellow staining of skin and mucous membrane, and diseases of the central system can be actively treated. The cure rate of insecticidal treatment is high, but the dogs may become a pathogen carrier with their hole life.
key word:Immune-mediated hemolytic anemia(IMHA), Fever, Canine babesiosis infection.

Base information

Name: DA BAI
Breed: Samoyeh skewer
Sex: Male(No castrated)
Age: 8 months old
Body weight: 23.9kg
History: None
Main problem: Da Bai was found loss of appetite, keep diarrhea and was fever half a month ago, and there was no recovery.During the time.Owners had take him to animal hospital to give symptomatic treatment without any diagnosis, but didn’t work. The vaccinate history is complete. No deworming in this year.

canine babesiosis infection

Physical examination

Clinical examination showed emaciation(body condition scoring is 2/5), depression, pale mucosa and sensitive palpation of abdomen.Also can find tick infection on the surface.Heart rate is 80 bpm,there was no obvious abnormalities in cardiopulmonary sound.Respiratory is normal.According to the symptom such as pale mucosa,it may infer it had a anemia situation in his body. So I decide to do some laboratory examination to have a initial diagnosis.

Laboratory exmination

1.Table1 Complete Blood Count(CBC)

Project

Unit

Result

Reference Range

RBC(Red blood count

109/ L

 

3.6

5.65~8.87

HCT

109/ L

23

37.3~61.7

HGB

109/ L

8.6

13.1~20.5

MCV

fL

67.3

61.6~73.5

MCH

pg

23.9

21.2~25.9

MCHC

g/L

35.5

32~37.9

RDW

%

13.6%

13.6~21.7

RETIC

109/ L

44.9

10~110

WBC(White blood count)

109/ L

7.51

5.05~16.76

NEU

109/ L

 

5.56

2.95~11.64

LYM

%

0.65

1.05~5.1

MONO

%

1.29

0.16~1.12

EOS

%

0.01

0.06~1.23

BASO

%

0.0

0~0.1

PLT

109/ L

45

148~484

MPV

fL

0

8.7~13.2

PDW

%

14.2

9.1~19.4

PCT

%

0

0.14~0.46

2. Vcheck V200 for dog CRP test
Table 2.the result of the CRP testing

Project

Result

Reference Range

CRP

63  mg/L

≤20

3. Idexx Catalyst biochemistry CHEM10
Table 3. the result of idexx CHEM10

Project

Unit

Result

Reference Range

GLU(Glucose)

mmol/L

4.98

4.11~7.95

CREA(Creatinine)

mg/dL

92

44~159

UREA

mg/dL

11.0

2.5~9.6

BUN/CREA

 

30

 

TP(Total protein)

g/L

55

52~82

ALB(ALBUMIN)

g/L

15

23~40

GLOB(Globulin)

g/L

40

25~45

ALB/GLOB

 

0.4

 

ALT(Alanine transaminase)

U/L

316

10~125

ALKP(Alkaline phosphatase)

U/L

193

23~212

4. IEDXX cPL test

Project

Result

CPL

Positive(+)

2.5 Microscopic examination of blood smear

Picture 1 The result of the blood smear

canine babesiosis infection

2.6 Universal Real-time PCR Kit for Nucleic Acid Extraction of Babesia Cayudi BAB (Probe Method)

Project

Result

babesiosis

Positive (+)

The analysis of the diagnostic

The differential diagnosis of this disease are anemia of chronic disease,caval syndrome,certain neoplasia such as lymphosarcoma,hemangiosarcoma,and ehrlichiosis.Zinc toxicosis,splenic torsion,leptosirosis are also the differential diagnosis,but they are rare. We know thae this cases symptom include fever, diarrhea about half a time, Although the owner went to the take a medication, but there were no obvious improvement.The dog had a history of diarrhea and fever, and had used anti-inflammatory drugs and “Huoxiang Zhengqi Shui” in other hospitals, so the possibility of poisoning could not be ruled out.Most part of disease is limit,which means the patient which is diarrhea can recovery or medication by themself for few days.On the contrary,the spirit of Da Bai worse and worse,So in this case,we might do more examination to find what the really reason of this symptoms.Through simple interrogation and basic inspection, found that the affected puppies mucosa pale, weakened slightly skin elasticity, abdominal palpation sensitive, with a tick infection.we get 3 important information.1)No deworming but always walk dog around the park.2)anemia by checking the pale mucosa.3)Fever.
After a series of laboratory tests, it was found that CRP of the dog was increased that mens there were inflammation in his body; HCT, HGB and the number of red blood cells decreased sharply in the routine blood examination; ALT indexes were all increased by multiples and albumin decreased in the blood biochemical examination.
The result of the Complete Blood Count is RBC infer there is a moderate regenerative anemia.Leukocytosis,neutrophilia is nonspecific and  thrombocytopenia.Results of biochemistry are normal except UREA(high may association with Azotemia ,or dehydration consistent with clinical examination),ALB(low may association with inadequate nutrient intake,consistent with loss of appetite,infer the hypoproteinemia)and ALT (high may association with the cellular damage).The most important finding is the morphology of parasite under the microscope.CPL test was positive too.In general combining all this result,we have a preliminary judgment for blood parasite infection.The define what blood parasite is,we should perfoem PCR test,and the result of this case is positve,Babesia infection.
The diagnosis was babesia infection, pancreatitis, and the possibility of cholestasis was not ruled out.

Treatment

  1. Atovaquone3mg/kg tid
  2. Azithromycin 10mg/kg sid
  3. Fluid transport therapy by LRS
  4. Liver protecting treatment
  5. Giving iron-nutrition supplement

canine babesiosis infection

Before therapy: According to the statistics of clinical cases in our hospital, the time of recurrence of most cases is generally 1-4 months after recovery, so communicate well with the master in advance. On the one hand, the master is easy to cooperate with treatment when the recurrence occurs, on the other hand, the master will pay attention to observe during this period, and the abnormality can be found earlier when the recurrence occurs, and receive treatment earlier. The high recurrence rate of puppies may be related to the incomplete development of their immune system. In addition, the author found that if the activity of the affected dogs can be well controlled after recovery, and the stress can be reduced, the recurrence rate can be reduced to a certain extent. The recurrence rate is the highest within 4 months after recovery, and the recurrence rate is rare after six months to one year.
The choice of treatment: Atovaquone (13.3-13.4 mg/kg PO q 8 hrs given with a fatty meal), in combination with azithromycin (10 mg/kg PO q 24 hrs for 10 days) can eliminate both acute and subclinical B. gibsoni infections in some dogs.Parasitemia may only be eliminated temporarily.Atovaquone resistance may become a concern over time.Treatment of B. conradae is similar to B. gibsoni but a 10-day course must be given to fully eliminate the parasite.Blood transfusions may be necessary for severe hemolytic anemia. Glucocorticoid use is controversial because it may worsen parasitemia. Evaluate and correct dehydration and acidosis. Start specific therapy for any concurrent diseases (e.g. ehrlichiosis, leishmaniasis, hepatozoonosis).6,31-33,36 See the appropriate Canine Associate chapters for treatment of serious complications, such as acute renal failure, DIC, pancreatitis, etc.

canine babesiosis infection

After therapy:The animal’s condition improved slightly and the spirit got better.We were happy to see his visible mucous membrane was light pink.After a week of therapy,there were no vomiting, willing to eat chicken, canned and dog food. After two weeks of treatment, he was reexamined in the hospital. PCR was negative for babesia, and blood routine showed that the number of red blood cells was within the normal range.

Prognosis

Prognosis depends on the infecting strain and the patient’s immune capabilities.1,6 Splenectomized individuals usually have a worse prognosis.Due to dehydration, moderate anemia, angular, shortness of breathing,loss of appetite, diarrhea, preliminary diagnosis Canine Babesiosis infection, anemia, pancreatitis, the injury of liver and kidney are possible. To treat the primary cause ,we should kill the worm and take a symptomatic treatment (blood nutrition supplement (giving iron preparation)as well as liver protective medicine, glucose, lactic acid liquid.Giving antibiotics to prevent potential infection is vital.Monitoring the blood once or twice per day to avoid the anemia become worse.If the Hct get down under 15%,and the weakness improves, i will consider to give a blood transfusion treatment to maintain blood volume for life.And we should have the communication with pet owner with this dangerous situation. After the the treatment of the symptomatic treatment and the administration of babesiosis drugs.

canine babesiosis infection

Summary

Babesiosis is reported in worldwide mainly found in United States,Australia, and Asia for thousands of years.Only puppies and immunosuppressed adult dogs will develop the disease, while most dogs infected with Babesia gibri will show severe clinical symptoms. Both canine babesia and gibberella babesia have been reported in the south of China. A study in the United States showed that dogs infected with Babesia Canis may only carry the disease and do not show obvious symptoms.Most people have never heard of canine Babesia infection although they have caused red blood cell destruction.The babesia is spread by ticks(only limited to specific tick species we will tall later) and is particular significane to racing greyhounds,American pit bull terrier,Sataffordshire terrier,and American bull.Humans may be infected by babesia as well.There are over 120 species of babesia but only a few are found in the United States and transmissible to dogs. We know that the transmission can occur through a tick bite.In addition to tick bite transmission, babesia can also be transmitted through blood transfusion, bite by carrying dogs, and transplacental infection is also a suspected transmission route. The cured dogs will become pathogen carriers, and it has even been reported that they will develop certain immunity, but there is a risk of immune-mediated complications, and the low immunity will recur in a certain stage, so they cannot be used as blood supply dogs or exported to non-epidemic foci.If the dog are infected,incubation occurs over 7-21days. The pathogenic species in transmission are Lxodes,Rhipicephalus,Dermacentor,Haemaphysilis and Hyalomma spp.Rhipicephalus sanguineus is the most common vector we can find in the USA.
Intraerythrocytic babesiae are ingested from the blood of an infected host by a vector, usually a tick of the family of the Ixodidae.The infected red blood cells are often digested and destroyed within the tick midgut.The small proportion that survive transform into gametocytes, followed by zygote fusion. They then invade the midgut epithelium. Zygotes undergo meiosis, transform into motile ookinetes, and cross the hemocele of the vector. Babesiae go through asexual reproduction, which results in sporokinetes that spread to all organ systems within the vector and remain there for life. Interestingly, ticks infected with Babesia spp. tend to have diminished maturation, although some Rhipicephalus spp. are developing a tolerance to the protozoa.Reproduction and multiplication of Babesia spp. within blood result in clinical signs of disease.12 These signs are primarily related to hemolytic anemia and thrombocytopenia.6 Pathogenicity varies depending on the strain.1,6 Infection may be more severe, and may be clinical in previously splenectomized or asplenic patients.
Some infections in dog are usually sub-clinical. When the clinical disease occurs, it often takes two forms,hemolytic anemia (most common) and multi-organ dysfunction (rare). The most severe clinical form is often caused by the B.canis rossi.Occasionally, disseminated intravascular coagulopathy (DIC) can occur from hemolytic and vascular injury followed by destruction of platelets and consumption of coagulation factors,it is a very dangerous in dog when DIC happens.

About human Babesiosis

At last, I will introduce the huaman babusiosis infection to you. The species of Babesia which infected animals should not pose any problems to people with those are in normal immune systems. People with compromised immune-systems or people who have had their spleens removed may have some concerns,which exist the risk of infection. In the U.S., babesiosis usually occurs on the East Coast and along the Great Lakes and stems from tick bites. Most symptoms are mild or easily treated but a five percent mortality rate has been reported. The usual organism is Babesia microti.

A case of a canine dermatophytosis

Abstract

Dermatophytosis is an infection of hair,nail and superficial layers of the skin which is caused by fungal species.Dogs can be exposed to infective dermatophyte spores by direct environment,animal-animal or animal-person especially the puppies.To help you have a better understanding of this disease,I will try to tell you what the main symptoms Dermatophytosis are,and explain the diagnosis and treatment for it.

Bases

Male,Spayed,
Breed:MALTESE DOG,
Age:1 year old
Name:Secret
Body weight:2.4kg
TPR:normal

1.Before visit:Owners find a round scurf on his back yesterday,and secret has been scratched hisself 3-5 per day,the frequency of the scratching increased recently.It has been about 5 days.Vaccinating and deworming on time.There is no contact to other animals during this time.But the owners are always walking dog near park.
2.Symptom:Hair loss,pruritus

A case of a canine dermatophytosis

The picture of the lesion of Secret,we can see a area of hair loss and he was itchy.

Clinical examination:TPR:normal,we can find a 2-3 cm length of scurf on his back
Laboratory examination:

A case of a canine dermatophytosis

The result of the Wood’s Lamp Examination: positive(+)

A case of a canine dermatophytosis

The result of the Microscopic Examination:fungus element in Microscopic view.10 X magnification

A case of a canine dermatophytosis                    A case of a canine dermatophytosis

The result of the Fugal Culture :we ca see pale colonies with a red color changing in the culture cup

Diagnosis

Dermatophytosis,Microsporum canis infection

Treatment

In this case,I made a plan to treat(see below),the reason i will talk in the conclusion.
1、Itraconazole 5mg/kg q.d p.o until mycologic cure
2、Enviroment managent
3、Wearing collar for 7 days

NOTE: Itraconazle is a liquid formulations,it can be administered with or without food. For non-liquid formulations, administer with food for maximum absorption and bioavailability. Recent findings indicate that bioavailability between solutions and non-liquid formulations are not clinically significant so dosage adjustment for different formulations are not necessary

Outcome

A case of a canine dermatophytosis

After a week of curing.We are happy to find the affected area gets better,and the owners tell us his scratching behaviors becomes less frequent.

Conclusion

We should use topical medicine to therapy before the results of the fungal cultures.
We must know that Dermatophytosis will not only infect the animals,but also our human being. Microsporum canis, Trichophyton spp and M gypseum are the most common pathogens we can see in the patients.Dogs of all ages and breeds can be affected,puppies and those immune system become weak are predisposed.In my opinion,there are no tendecy of breeds in the Dermatophytosis. Pruritus,erythema,and the circular hair loss are the typical clinical signs.It may be affect any area on the body,but the most area we can see is the face,around the ears,and distal extremities.Here are some diagnostic methods we can use.Don’t foget dermatophytosis can also act as a reverse zoonsis with human dermatophyte infection occurring in dogs and cats.If a lot of animals are infection,we should separate them at first.And if the source of the feline infection is a person,an anthropophilic dermatophyte may be isolated on culture.

Here are some clinical finding or symptoms would be described in hospital:

Afebrilea, alopecia, alopecia circular, alopecia truncal, cutaneous crusts, scabs, cutaneous erythema,hyperemia,cutaneous fistula,cutaneous hyperkeratosis, cutaneous hyperpigmentation, cutaneous nodules, cutaneous papules, cutaneous plaques, cutaneous pustules, pyoderma, cutaneous scales,cutaneous surface dry, cutaneous ulcers, dermatitis, dermatitis facial,dermatitis miliary, dermatitis papular,dermatitis pustular, edema or swelling, edema or swelling cutaneous, edema or swelling subcutaneous, excoriation, self mutilation, fistula, forefoot painful, forelimb painful,hair coat poor,hindfootpainful, hindlimb painful, hyperkeratosis,hyperpigmentation,lymphadenopathy, Nail bed, paronychial inflammation, Nails, claws deformed; onychodystrophy, Nails, claws painful, Nails, claws sloughed; onychomadesis, Nails, clawssplit; onychoschisis, pain, pruritus, subcutaneousfistula, subcutaneous nodules, ulcers, weight loss, zoonosis,  zoonoses.

Diagnostic ways to help us confirm dermatophytosis

As we have mentioned the dermatophytosis is a potentially zoonotic infection,and it has many different clinical presentations. The major differential diagnoses include many diseases, which can also perform hair loss,scale and crusts,such as food allergy, hypersensitivity with secondary pyoderma. Mite likes cheyletiellosis, demodicosis. Even the uncommon disease. Pemphigus foliaceus. So with a lot of similar symptom diseases,how can wee easily to diagnose it ?
I will introduce some clinical examination methods usually used in this disease.
1.Microscopic Examination of lesions/affected area:the skin scrapings position should be take in the Junction of the affected and healthy area.Giemsa staining is a convenient methods to help us find the fungal elements.Cover slips can be placed on slide specimens and view at 4x or 10x magnification.
2.Wood’s lamp examinations :this is a easy examination to search the suspected position.Also we might know the reporting that 30% – 50% positive reaction in Wood’s lamp examinations,which means a patient can have dermatophytosis but could be negative on Wood’s lamp examination for a variety of reasons such as improper Wood’s lamp examination,infection with a dermatophyte species that does not fluoresce and lack of infected hairs(infection is in the epidermis or in matted hairs under skin crusts) .It is a tool to monitor response to treatment and use to take a initial diagnose.The advantage of this examination is quick and low-cost.
3.Fungal Culture :the most commonly used culture medium is dermatophyte test medium(DTM).This should be incubated at room temperature and monitor every day.Microsporum canis cultures can be done at day 14 if no growth in the medium.Confirming diagnosis must via Microscopic identify.We can see a pale,flat,and fluffy gross colonies if growth.
There are some veterinaries think that all Dermatologic lesions are dermatophytosis.,but it is wrong.Confirm the diagnosis should through a positive fugal culture and/or KOH direct examination.
4.PCR(polymerase chain reaction)technique:Dermatophyte DNA can be amplified and identified by using polymerase chain reaction. PCR results are usually received faster tnat the dermatophyte culture results.Diagnosing dermatophytosis is vecy straightforward in human being. However, diagnosing dermatophytosis in veterinary patients is less straightforward. Veterinary patients can carry dermatophytes on the hair coat and/or skin yet not have dermatophytosis (i.e., carriers). Veterinary patients can also harbor non-pathogenic dermatophytes or other fungi on the hair coat and/or skin.Additionally, many factors can affect the performance of dermatophyte PCR tests including:PCR test type,laboratory technique and sample quality.In my experience,PCR technique is not a convenient we have usually used in veterinarian diagnosis.

The key point of the management in dermatophytosis

In healthy animals,dermatophytosis are self-healing;The treatment principle is shorten the course of disease and limit infection.Dermatophyutosis is not a life threatening zoonotic disease,but it is important  to realize that the therapies are multi-mode.The methods include Cleaning,Confinement,Topical therapy,and Systemic Therapy(Depending the animal situation).

Systemic Therapy

In this cases,Although a round scruff found in Secret for a short time,he scrathed the body may have a contagion risk. is a Itraconazole is an anti-fungal agent that has excellent activity against dermatophytes.The suggesting dosage is 5-10mg/kg q24 hrs,it has a best absorbed in an acidic environment,so give it with food.The most commne side effect is anorexia,although elevation of liver enzymes can occur,so we’d beeter to monitor the activity of alanine aminotransferase assayed by biochemistry.Administration of Itraconazole orally(5mg/kg) as a system therapy to control the infection in this case.System therapy is considered to be a important way to eradicates infection in the skin and hair follicle.Terbinafine(30-40mg/kg) is another effective and safe medicine for us to uses.T

Topical therapy

ropical therapy is a good method in the initial infection when pathogen isn’t spread the health skin.Antifungal topical therapy is usually used to kill infective spores on the hair coat. Topical therapy limits the spread of dermatophytosis by decreasing direct animal-to-animal contact, as well as the number of infective spores in the environment. It also reduces the risk of false-positive culture results from the presence of infective spores on the hair coat in the absence of active dermatophyte infection. Most research on topical therapy has been conducted in cats. The World Association for Veterinary Dermatology currently recommends twice weekly application of lime sulfur, enilconazole, or miconazole-chlorhexidine shampoo.

Environmental management

Environmental decontamination is very important because it can removes fur that contains fungal spores. These infective spores can be picked up by animals and humans in the home, and they are responsible for re-infecting treated patients, though this is rare, as well as causing false-positive dermatophyte cultures during treatment monitoring. Thus, environmental decontamination does two things: 1) minimize false positives on the dermatophyte culture; and 2) shortens the time for treatment of the patient.

Behavior management

Considering the transmission of the disease.Secret should wear the collar to avoid licking the affected area.By the way,when puppies are in a socialization times,owners not only should pay attention to have a cleaning awareness but also keep playing with him for his socialization.I am not suggest contacting with the other canines.Wearing gloves to avoid self-scrathing is vital to avoid secondary skin trauma.

The timing to collar release and medicine depend on the infected patients,it should be monitored until mycologic and clinical cure are achieved.

Prognosis

Prognosis is excellent in the dermatophytosis. Resistance to antifungal therapy is uncommon and treatment failures are usually due to not using monotherapy (topical or systemic only), premature discontinuation of therapy, or poor environmental conditions (e.g. inadequate environmental decontamination, environmental stress). In some cases, veterinarian need to recheck once or twice a week. In real situation,most owners can not bear the price.So after a week,owners didn’t decide to take a fugal culture to Secret. So we strongly to advice owners to keep a look at his clinical symptom, keep on giving itraconazole orally for 14 days. Prognosis is good until now.

A case of diagnosis and treatment of a dog with heat stroke

Abstract

Heat stroke often occurs in hot summer weather, and is also known as heat exhaustion clinically. According to the cause, it includes sunstroke and heat stroke. Sun exposure refers to a disease in which animals are exposed to direct sunlight on their heads in hot seasons, causing meningeal hyperemia and acute brain parenchyma lesions, resulting in serious obstruction of the central nervous system. Heat stroke is a disease that causes severe central nervous system dysfunction due to excessive heat accumulation in animals in a humid and hot environment. The disease is characterized by markedly elevated body temperature, respiratory and circulatory disturbances, and neurological symptoms.

diagnosis and treatment of a dog with heat stroke

1.Case introduction

Animal:Huanhuan
Breed: Samoyed
Gender: male dog (castrated)
Age: 5y
The owner went to the doctor on September 10 and complained that the sick animal, Huanhuan, went to the beauty shop for bathing and styling yesterday. When he was picked up in the evening, he found that he was sluggish, did not eat or drink, and had vomiting and bloody stools in the early morning of this day. There is no other medical history, and the history of deworming and immunization is complete.

2.Basic Inspection

It can be seen that the dog is obese, depressed, sunken eyes, dry nose, salivation, palpation body surface temperature is higher than normal, skin rebound time is prolonged, and it is impossible to stand and walk. Complete history of immunization and deworming. Body temperature (rectal temperature): 41°C, weight: 30kg, heart rate 119 beats/min, rapid breathing, CRT=2s, red tongue.

3.Clinical examination

Routine blood test (CBC)

Project

Detection value

Reference

WBC(White Blood Cell Count)

10.7×103/uL

6.0~17.0

RBC(Red Blood Cell Count)

8.49×106/uL

5.5~10

HGB(Hemoglobin)

22.0g/dL

12.0~18.0

HCT(Hematocrit)

71.3%

37~55

MCV(Mean Corpuscular Volume)

84fL

60~77

MCH(Mean Erythrocyte Hemoglobin Content)

25.9pg

19~24.5

MCHC(Mean Erythrocyte Hemoglobin Concentration)

30.9g/dL

30~37

PLT(Platelet Count)

193×103/uL

200~500

LYM%(lymphocyte Percentage)

3.1%

12~30

OTHR%(Other Cell Percentage)

86.1%

60~86

EO%(Eosinophil Percentage)

10%

2~10

Blood biochemical examination

Detection item

Detection value

Reference range

ALB(Albumin)

30 g/L

23-40

ALT(Alanine Aminotransferase)

434 U/L

10-100

ALKP(Alkaline Phosphatase)

114 U/L

23-212

AMYL(Pancreatic amylase)

847 U/L

500-1500

BUN(Urea Nitrogen)

5.9 mg/dL

7-27

CREA(Creatinine)

106 mg/dL

27-106

CK(Creatine Kinase)

49 U/L

10-200

AST(Aspartate Aminotransferase)

124 U/L

0-50

PHOS(Phosphorus)

2.02 mg/dL

0.81-2.2

TP(Total Protein)

58 g/L

48-72

TBIL(Total Bilirubin)

2 umol/L

0-14

GLOB(Globulin)

29 g/L

23-38

GLU(Blood Glucose)

5.41 mmol/L

4.11-7.95

CHOL(Cholesterol)

4.41 mg/dL

2.84-8.26

CA(Calcium Ion)

2.65 mg/dL

1.98-3

 

Blood gas electrolyte analysis

Detection Item

Detection Value

Reference Range

PH(PH Value)

7.36

7.31-7.42

PCO2(Carbon Dioxide Partial Pressure)

36 mmHg

32-49

HCO3-(Bicarbonate ion concentration)

18.6 mmol/L

20.0-29.0

AnGap(Anion Gap)

25.3mmol/L

 

tCO2(Total Carbon Dioxide Content)

 19.5 mmol/L

21-31

Na+(Sodium)

157 mmol/L

144-160

K+(Potassium)

4.2 mmol/L

3.5-5.8

Cl-(Chlorine)

118 mmol/L

109-122

 

4.Initial diagnosis

Combined with clinical features such as acute onset and laboratory test results, a preliminary diagnosis of heatstroke was made

diagnosis and treatment of a dog with heat stroke

5.Treatment plan

  1. Physical cooling: place the dog in an air-conditioned place, spray alcohol on the body surface, the soles of the feet, and place ice packs on the abdomen, armpits, and neck
  2. Lactated Ringer’s solution:145mL/h *24h
  3. Synulox:20mg/kg s.c

During the treatment, the body temperature was closely monitored. When the body temperature returned to 39.5°C, the patient was transferred to the hospital for observation. The next day, the body condition improved. After communicating with the owner, take it home for nursing.

6.Analysis and discussion

In animals with elevated body temperature, the causes include heat stroke, infectious diseases, immune-mediated diseases, poisoning, and tumors. Combined with the current season, animal species, consultation and the disease show more typical clinical characteristics. In summer, sick animals often suffer from heat dissipation barriers in the body due to long modeling time during grooming, until they have clinical symptoms such as vomiting after returning home.
Heatstroke is an emergency in clinical practice. After the initial diagnosis of heatstroke, it is necessary to prepare for emergency treatment in time, including emergency medicine, establishment of intravenous access, and monitoring of physical signs. Doctors also need to communicate the risk with the owner. The prognosis is generally good when the disease is detected early, but it can lead to sepsis or even multiple organ failure and death in the long course of the disease.


A.Before therapy:

Physical examination showed that the animal was depressed, body temperature (rectal temperature): 41 ℃, dehydration; laboratory examination showed increased HCT in the blood routine, which was consistent with the dehydration in the physical examination. Due to the acute attack of the disease, it may lead to leukocyte inflammation There was no obvious abnormality in the indicators. In other cases, CRP, a more sensitive inflammatory indicator, could be added for monitoring. Biochemical examination showed that ALT and AST liver enzymes were elevated, indicating that there was cell damage in the body, which may be caused by heat exhaustion. In blood gas and electrolyte analysis, serum potassium is often decreased in the early stage of heat stroke, and serum potassium is increased in the late stage, and metabolic acidosis, but no obvious abnormality was found in this examination.


B.In treatment:

The main principles of treatment are hypothermia and cardiovascular support. The goal of body temperature cooling is to drop to normal body temperature. In this case, conventional physical cooling methods were used. Alcohol and ice compresses were used to promote the animal to dissipate heat. In view of dehydration and a history of vomiting, if there is no obvious abnormality in electrolytes, routine lactated Ringer’s infusion is performed according to the maintenance dose of 60 mL/kg and 8% dehydration in large dogs to correct the dehydration. In addition, the antibiotic Solenol was administered subcutaneously at a conventional dose of 20 mg/kg to prevent secondary bacterial infection.


C.After treatment:

Because this case was discovered early and received timely treatment, the spirit of the dog recovered after one day of hospitalization. In addition, there was no obvious abnormality in the liver and kidney indicators in the laboratory examination. After communicating with the owner, it was brought home for treatment. Nursing, but still need to increase the appropriate temperature at home, give drinking water regularly to observe their mental status.

diagnosis and treatment of a dog with heat stroke

7.Summary

Canine sweat glands are underdeveloped and only present in the foot pads. For Samoyed breeds, their hair is thicker and their tolerance to heat itself is weak, and they cannot effectively dissipate heat through breathing in a sultry environment for a long time. At the same time, rapid breathing will also take away a lot of water, resulting in the occurrence of heat stroke. . The manifestations of heat stroke are usually increased body temperature, shortness of breath, a large amount of salivation, and neurological symptoms may also occur. Initially, the animals may be excited, restless, insane, and then ataxia, lying on the ground, confusion, and heart failure as the disease worsens. , Mucosal cyanosis, mouth, nosebleed secretions, muscle spasms, convulsions and even acute death.
For heat stroke diseases, pet owners need to increase their awareness of prevention. In the hot and hot season, you should do a good job of preventing heatstroke and cooling, and you need to keep the indoor ventilation, and the temperature is suitable. Avoid walking the dog at noon, try to choose morning and evening walks, and give appropriate and clean drinking water before going out, but avoid giving ice water directly, so as not to stimulate the heart. For dog breeds with strong and thick hair, such as Chow Chow, Alaskan and Samoyed, the hair on the body surface should be shortened in time, especially the hair in the foot pads, which will help the foot pads to dissipate heat. Short-nosed dog breeds such as myna and bullfighting are also prone to heat stroke.
When symptoms of heat stroke occur, it is necessary to take cooling measures immediately. The options include (1) timely remove the clothing or shoulder straps on the animal (2) immediately move to a cool and ventilated place, and keep the environment quiet (3) give cool drinking water (4) ) Wipe the body surface with alcohol, and apply cold compresses (5) enema (6) drugs to cool down. In some materials, the method of cold water enema is used, but this method is not recommended. It is recommended to use normal temperature water enema. This is because it is not easy to control the speed of lowering the body temperature, and beware of shock caused by the rapid drop in body temperature.