A Case A Week for Veterinarians
Providing veterinarians a challenging case for brain storming every week ... A Case A Week a website for Vets prepared by Dr Mofya Saul and Dr Rajesh Banga.
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Monday, December 22, 2008
Case 8
A six month old, intact, male, mix breed dog (pothound) was presented to AcaseAweek Clinic with a history of anorexia, weight loss and lethargy. The dog has an indoor/outdoor lifestyle, is fed puppy Science Diet, is up to date on its vaccinations and is treated for ectoparasites with Adam’s spray. The owner was away during the summer and upon return found ticks on the dog. There are four other dogs in the household, one of them is showing similar clinical signs and happens to be this patient’s brother. 

Physical examination revealed that the patient was mildly depressed, alert and responsive, had a temperature of 100.4ºF, heart rate was 100bpm, respiratory rate was 12bpm and weighted 18.2 kg.

Ears, eyes, nose, throat: mild black, thick, tarry exudate on both ears. No ocular or nasal discharge observed.
Mucus membranes: grey, pale and slightly yellow (icterus). CRT<2>
Lymph nodes: generalized lymphadenopathy.

Laboratory tests:
Snap test: Ehrlichia, Heartworm, Anaplasma and Lyme disease negative.
CBC: unremarkable, except for mild eosinophilia.

Chemistry profile:
  • AP 1259 U/L (46-337)
  • ALT 673 U/L (8-75)
  • Glob: 4.1 g/dL (2.3-3.8)
  • TBIL: 1.3 g/dL (0.0-0.8)
Urinalysis- unremarkable.

What is your tentative diagnosis? Give list of differentials.
What diagnostic test(s) will you perform to confirm your diagnosis?
How will you treat and manage this case?

posted by Dr Banga's Websites @ 12:00 AM  
  • At December 22, 2008 at 1:54 PM, Anonymous Anonymous said…

    Tentative diagnosis list:
    The symptoms are highly suggestive of Ehrlichia or Anaplasma infections but we rule those with negative SNAP test and no signs of Thrombocytopenia.

    Having mentioned that we are left with 1)Leptospirosis infection 2)EFF
    3)Canine herpes virus infection 4)Any condition that causes hepatitis.

    Further diagnostic tests needed to confirm are 1) serologic test usind both acute and convalscent phases and observing the samples under dark field microscope for detection of Leptospira infection,
    2)Demonstration of fluke eggs in feces for EFF.
    3) Abdominal radiographs to look at the liver.

    Treatment plan:
    1)Supportive... providing fluids,elctrolytes
    2)Antibiotics: Amoxicillin, doxycycline

  • At December 22, 2008 at 5:27 PM, Blogger Dr Banga's Websites said…

    That is good explaination ... the solution will be posted on Friday ... more people can add to the above information till then.

    Thanks for commenting.

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