Fever 105

Swarupmay Majumdar ‎1.5 yrs old male St bernard dog, moderate body condition , H/O being on 4 days treatments for not taking food in some vet hospital.diagnosed to be having oral ulceration and treated with fluids,B-complex and Vit C. there is no improvements. Further, history collected as he is unwilling to walk, walks in one sides, can not tolerate walking at all.sits down and froth. he had been vaccinated and dewormed. he is with another 4 dogs which all are healthy. chief complaint: not eating, reluctant to walk, breathlessness.

30 January at 12:38 · Comment · · Flag

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    Swarupmay Majumdar

    continued:
    P/E: standing posture, active and alert. temp-105*f. Ln- slightly enlarged. MM pale but not cyanotic. mild dehydration. expiratory distress. swelling on brisket. no limb swellings. motions and urine normally voided, no vomiting since yesterday. H/R- increaed.
    x-ray : abd & chest. chest: mild effusion. cardiac shilhoute round in appearence and feels enlarged. Abd: nothing abn detected. Blood report waited: immediately avl: bun12,creat 0.6,sgpt 37,sgot 55; waiting for TC DC Platelet and HB.
    suggestions please, the case is now on drips and any immediate suggestions are welcome.

    30 January at 12:39 · · Report
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    Swarupmay Majumdar total count 38000,hb 10 platelet 2.5lakhs

    30 January at 14:04 · · Report
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    Saurabh Saxena apply glcerine+betadine on oral mucosa.reports look ok to me.how do u get so fast cbc results .have u got in clnic haem. analyzer or wat??

    30 January at 14:24 · · Report
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    Ashwin Nambiar Can it be a respiratory infection considering the leukocytosis and radiograph findings? How about adding an antibiottic, frusemide, deriphylline and dexamethasone to the treatment regiemen?

    30 January at 15:12 · · Report
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    Swarupmay Majumdar

    ‎@ saurabh: we get it done at a lab which has hemo analyzer & collect the result over the phone.
    @aswin: this can be a case of respiratory infection also. as we were waiting blood report which takes 1 hr,we delayed any thoughts of using the steroids. after the reports came,it showed the dog has a TC of 38000. that makes it difficult to take help from steroids as the situation may go wrost. on deriphylline sometimes dogs collapse. I used Oxygen @ 1.5lit/min. that is to help him breathe easy. I was worried whether to use lasix as the report was not clear. after reports , I used 1 ml lasix.
    I have used 2 antibiotics- ceftriaxone + gentamicin. and used or inserted IV catheter suceesfully for the first time! this will help me to give antibiotics twice a day, keeping in mind the high Total counts.

    30 January at 15:30 · · Report
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    Ashwin Nambiar with oxygen can nebulisation with salbutamol (asthalin) also be done? what other differential diagnosis do you have in mind? Can u plz tell me the rationale in using gentamicin...we dont use it here much - so i dont know..thanx

    30 January at 15:50 · · Report
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    Swarupmay Majumdar

    ‎@ ashwin: I can use repsules of asthalin,betacort or anything for nebulization. but nebulization is not very effective in dogs. I did it many times. Now a days I use plain water or mix Tincture benzoin in nebulizer based on condition ( not with O2) . absolutely theres no problem with nebulization with o2.
    
    dd: 1. pericarditis- most likely
    2.DCM_ dilated cardiomyopathy- likely
    3.gastric forgein body- very likely
    4.hip dysplasi- unlikely
    5. PUO
    
    rationale for gentamicin: hospital anitibiotic of choice,always avl in hand. works against smooth organ infections ( anerobics). but it is not a very good choice, I think I should have gone with Ornidazole.

    30 January at 16:04 · · Report
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    Gautam Unny pl put up the chest x rays, and nebulisation with budenoside and theophyliine is a good avoid. avoid dexa with such high tlcs. lasix can be tried. yes some antibiotic for anerobes must always be initiated.

    30 January at 16:49 · · Report
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    Swarupmay Majumdar status at 8.30 pm: the dog came walking,temp 103.2*f.he had many attempts in thowing his lungs contents/ cough as owner tells. tried to eat something but he could not as there waqs so much of expectorations. plan to continue with fluid,antibiotics bid IV , ematics ,melonex if fever. any other suggestions?

    30 January at 17:20 · · Report
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    Madhurita Gupta try amoxicillin i/v and fluids and can give b complex just chk the TPR as temp is high as such .u can try dexa to stimulate him

    30 January at 21:55 · · Report
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    Swarupmay Majumdar status on 31..1.2010: so much improvements. temp 102.8*F. he is better and most of his symptoms are now stabilized. just gave antibiotics alone IV.

    31 January at 08:57 · · Report
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    Swarupmay Majumdar I have got the x-rays with me.They are traditional ones.I dont know how can I digitalize them to put on SAVIN. Can anyone guide me please?

    31 January at 09:54 · · Report
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    Ashwin Nambiar You just need to photograph them against a backlight and upload those photos. they come out pretty well.
    Dr Swarupmay and Dr Gautam, why do you advise against using Deriphylline/ theophylline? any untoward reactions?

    31 January at 17:42 · · Report
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    Gautam Unny dc, typo error, i typed use budesonide and theo, and avoid dexa since tlc is high. no problems whatsoever with theophylline

    01 February at 05:53 · · Report
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    Swarupmay Majumdar condition on 1.2.10: temp 100.3*f. eating but finds difficult to swalllow. there is pain on both elbow joints. can it be due to respiratory distress? or elbow dysplasia?

    01 February at 10:24 · · Report