unilateral epistaxis

Swarupmay Majumdar ‎6yrs m Gsd H/O bleeding from nose (left side). Was on treatment for 7 days for Tick fever with Microdox dt 2tabs bid po as adv by Vet college. Normal appetite,motion,no other history.
PE findings: fresh clotted blood vomiting, bleeding profusely from left nose.
T 102.6*f, Mm mild pale and icteric, LN- not enlarged.Dypnea, palp NAD.
Blood collected and suggests: HB 15.7,TC-13600, N79,L17,eosin-02.Platellet 2.64akhs,BUN 16.5,sr creatinine 1.6mg/dl,ALT 70,Alp 383.

Any suggestions?

13 April at 15:42 · Comment · · Flag

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    Saurabh Saxena get an x ray done to rule out nasal polyp or tumour.

    13 April at 15:47 · · Report
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    Swarupmay Majumdar ok. but do I need to continue with Doxy?

    13 April at 16:32 · · Report
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    Joseph Cyrus continue with doxy. collect nasal washings for cyology and tumor!

    13 April at 17:29 · · Report
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    Sarabjit Singh dont go for doxy, instead use chloramphenicol @50mg/kg b/wt twice a day and strictly i/v along with revici and vit k for atleast 3 days. treat it as ehlichiosis and go for imizol also. you can control the bleeding within 2days.

    13 April at 17:53 · · Report
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    Swarupmay Majumdar How effective is chloramphenicol in cases of E.canis? The report does not show any change in platellet count. can then too we can think abt ecanis?

    13 April at 18:30 · · Report
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    Joseph Cyrus in the initial phases. imizol with caution!!!!!!

    13 April at 18:48 · · Report
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    Joseph Cyrus why not enrocin?

    13 April at 18:50 · · Report
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    Sarabjit Singh the choramphenicol is third drug of choice in tick fever and ehrlichiosis and some times the blood report comes false when the disease is in subclinical phase.
    

    13 April at 18:53 · · Report
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    Sarabjit Singh also if you use you can use the cholamphenicol @50mg/kg b/wt in two divided doses.
    and use of prednislone in high dose can even reduce the nasal bleeding. even 30mg twice a day.

    13 April at 19:32 · · Report
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    Ajitesh Kumar i dont think its a case of tick fever. blood report does not suggest this. take abdomial x ray to see if there is any enlargement of liver or tumor in the liver.

    14 April at 14:04 · · Report
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    Swarupmay Majumdar why always think abt tick fever. I gurantee there was no ticks for last 6 months. and if it is tick fever why is the bleeding only from one side? unilateral bleeding may be related to nasal injury, nasal polipy,tumors, ..am I correct?

    15 April at 10:28 · · Report
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    Darsha Mapatuna

    put nasivion or rhynozole nasal drops 3 time per day and give vitamine k. there are no lateral or unilateral bleeding for any condition . what ever side or both side you have to rule out the other clinical sign and find out the condition.
    normally tick fever and E canis has nasal bleeding.according to you it may be E canis o

    15 April at 10:57 · · Report
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    Swarupmay Majumdar to tell u frankly, I used Stryptovit inj and found very good result. I also put him on Amoxy clav and some liver tonics. he is better. I stopped the Doxy on recieving blood report.

    15 April at 11:08 · · Report
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    Ajitesh Kumar wt was the blood report?

    16 April at 11:32 · · Report
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    Swarupmay Majumdar blood report is there , just click see more

    16 April at 16:59 · · Report