23 October 2011

Case for the week:

1.      Process of Tick Fever

2.      History

3.      Examination

4.      Blood test and Blood smear

5.      Treatment

1)      Process:

Dogs get Ehrlichiosis (Tick fever) from the brown dog tick, which passes an Erlichia organism into the bloodstream when it bites. There are three stages of Ehrlichiosis, each varying in severity. The acute stage, occurring several weeks after infection and lasting for up to a month, can lead to fever and lowered peripheral blood cell counts due to bone marrow suppression. The second stage, called the subclinical phase, has no outward signs and can last for the remainder of the dog's life, during which the dog remains infected with the organism. Some dogs are able to successfully eliminate the disease during this time. In some dogs the third and most serious stage of infection, the chronic phase, will commence. Very low blood cell counts (pancytopenia), bleeding, bacterial infection, lameness, neurological and ophthalmic disorders, and kidney disease, can result. Chronic ehrlichiosis can be fatal.
[Reference: http://en.wikipedia.org/wiki/Ehrlichiosis_(canine)#Disease_overview]

Babesia canis are protozoal parasites that infect red cells and can produce hemolytic anemia. Transmission is primarily by the brown dog tick.

[Reference: http://en.wikipedia.org/wiki/Babesiosis]

2) History:

Dog have been exposed to ticks

3) Examination:

Presented with symptoms of lerthargic-ness and loss of appetite, signs of pale gums which signifies anemia



Pale gums signify anemia

4) Blood Smear:

Reveals pathogen such as Babesia Canis and potential Ehrlichia Canisa

Babesia Canis in blood smear
[Reference: http://ahdc.vet.cornell.edu/clinpath/modules/rbcmorph/b-canis.htm]

Ehrlichia Canisa in blood smear
[Reference: http://www.marvistavet.com/html/body_ehrlichia_infection_in_dogs.html]

Blood test results before treatment:

Liver profile= Normal

Kidney profile= Normal

Hematology=

*Hemoglobin- 7g/dL  [Normal range: 12-18]

*Red Blood Cells- 2.8 x10^12/L [Normal range: 5.5-8.5]

White Blood Cells- 13.2 x10^9/L [Normal range: 6-17]

Packed Cell Volume= 0.19 [Normal range: 0.37-0.55]

Platelets= 52 [Normal range: 200-500]

Nucleated Red Blood Cells seen [Severe demand for RBC to be release from Bone Marrow]

No platelet clump seen

Blood test results after 1 day of treatment:

Liver profile= Enzymes increased

Kidney profile= Normal

Hematology=

*Hemoglobin- 7g/dL [Normal range: 12-18]

*Red Blood Cells- 2.9 x10^12/L [Normal range: 5.5-8.5]

White Blood Cells- 9.6 x10^9/L [Normal range: 6-17]

Packed Cell Volume= 0.2 [Normal range: 0.37-0.55]

Platelets= 64 [Normal range: 200-500]

No platelet clump seen but few giant platelets present

What is the importance of platelets?
a) Numbers:
The analyzer counts the number of platelets in the blood, and the reported platelet count gives a general indication of the clotting ability of the blood. If the number of platelets falls below a certain critical level, spontaneous bleeding may occur. A low platelet count may indicate a problem with platelet production in the bone marrow, or may signal the presence of disease that is causing the platelets to be used up or destroyed.  An increased platelet count often reflects excitement, exertion, or an activated bone marrow. In rare cases, an extremely high platelet count may indicate there is underlying bone marrow cancer.
b) Size:
The size of a platelet is related to its age; young platelets are large and plump, and older platelets are generally smaller. This can be important if the platelet count is low; the presence of large, plump, young platelets in the blood indicates that the bone marrow is functioning well, and is responding to the need for more platelets.
c) Appearance:
 Very rarely, bizarre giant platelets, or abnormal immature platelets may be found, and these may signal the presence of an underlying bone marrow disorder or cancer

[Reference: http://www.fetchdog.com/learn-connect/dog-resource-library/health/diagnostic-tests/Complete-Blood-Count-for-Dogs/D/300600/P/1:5:55:601:6103/I/AR000010025]

5) Treatment:

Supportative therapy: IV-drip of Dextrose Saline

For anti-bacterial activity: Oral Vibravet 100mg twice a day for up to 21 days

For anti-protozoal activity: Imidocarb 0.5ml

Working hours:
9.45am- 5.30pm

Admin stuffs completed:
Updated Client's database and found several empty details in older records