Signalment
- Age: 4 years
- Sex: male neutered
- Breed: Mixed Breed
- Species: dog
Disease Notes
- Certainty: confirmed
- Comments: Top differentials for his signalment and presentation included GI parasites, inflammatory bowel disease, dietary indiscretion (including foreign body ingestion), or bacterial overgrowth. Palpation of thickened intestines and other GI structures warranted that infiltrative
diseases to be added to the differential list such as inflammatory, infectious, or neoplastic etiologies. Vomiting was considered to be linked to the primary GI disease, and was thus not worked up separately.
All of his clinical signs can be linked to a primary GI disease leading to malabsorption and hematochezia. - Final Status: slightly better as of day 48 of treatment
Treatment and Outcome
Problem Notes
- Anemia And More: CBC:
-anemia (moderate, regenerative, normocytic, hypochromic); PCV: 28.1%
-mildly decreased plasma protein
-otherwise unremarkable
Chemistry Profile:
-hypoalbuminemia (1.4)
-hyperglobulinemia (3.9)--suspect falsely lowered if blood loss is present
-hypocholesterolemia (115)
-hyponatremia (137)
-otherwise unremarkable - Hematochezia: When assessed at the VTH at Virginia Tech on 02/04/16, it was stated "In this case, it is fairly certain that the blood loss is originating within the GI tract, given the obvious degree of hematochezia noted."
- MarkedlyThickened Stomach Wall: Abdominal Ultrasound:
-markedly thickened stomach wall and intestinal walls with occasional loss of layering
-moderate abdominal lymphadnenomegaly
-mild peritoneal effusion - Weight Loss: Clyde presented to the Veterinary Teaching Hospital at Virginia Tech on 2/04/16 for evaluation of coughing, weight loss, and chronic diarrhea of approximately one month's duration. Occasional but infrequent episodes of vomiting were also noted, despite Clyde retaining his appetite.
Treatments
- Slippery Elm
- Xue Fu Zhu Yu Tang
- Bu Zhong Yi Qi Tang
- Iron Supplements
- Pedialyte
- Omeprazole
- Sucralfate
- Ninja Red
- Thuja Essential Oil
- Jia Wei Xue Fu Zhu Yu Tang
- Red Asian Ginseng
- Spleen Support Formula
Notes:
Given Iron supplements. Omeprazole and sucralfate, yogurt and pedialyte. Herbs prescribed include: Slippery Elm, Xue Fu Zhu Yu Tang, BuZhong - Central Qi Tea pills, 1 tsp coconut oil daily.
Blood drawn 02/18/16 for CBC/Chem
HCT is low normal (36% (RR 36-60%)
Lymphocytosis (17.8 (RR 4.0-15.5 thousand cells/uL)
Neutrophilia
Mild monocytosis
Total Protein increased - 11.7g/dL (RR - 5.0-7.4g/dL)
Hypoalbuminemia and Hyperglobulinemia
A/G Ratio low. 0.3 (0.8-2.0)
Hypoglycemic - 51 (70-138)
Hemolysis - 4+
Diet is largely canned or kibble
Acupuncture points were stimulated
Notes: On B Vitamin supplements since 2/23/16
Acupuncture points were stimulated
Notes: Clyde was weighed on this visit. Since instituting enzyme addition to his diet, he has gained two pounds. His weight was recorded at 37lbs on March 11th, and at 38.8lbs 03/17/16. He is BAR, though still extremely emaciated (BCS 1-2/9). Owner reports that he seems to be more alert and stronger physically. She is interested in having a home-cooked diet developed for him, as the prescription canned food is expensive.
Diet is largely canned or kibble
Notes: None submitted
Acupuncture points were stimulated