Is this a pyo?

Re: Is this a pyo?

Mark Hedberg — Thu, 17 May 2012 20:17:00 GMT

Of course they're not. After all, puppies are valuable little darlings! :)

Re: Is this a pyo?

Robin Grimmer — Thu, 17 May 2012 18:06:09 GMT

saw her this evening and she's pretty much back to normal apart from still pu/pd. There's no vaginal discharge, rectal temp was normal and appetite was normal. So she's going to continue with her Synulox for now. The owners aren't particularly keen to spay her unless we have to.

Re: Is this a pyo?

CatherineThomas — Thu, 17 May 2012 16:04:08 GMT

I have seen a pyo with massively raised liver parameters and she was bright yellow. She was also really flat, almost collapsed. I operated on the pyo and kept her on a drip and she did eventually pick up, although we were thinking we might have to put her to sleep when she wasn't improving. I think she was in for at least 5 days before she was well enough to go home. Within a couple of weeks her blood values were back to normal. It doesn't sound like yours is as badly affected though.

(He does still owe us £300 3 months later, despite promising he would be able to pay and me keeping the bill as low as I could. But that's another story)

Re: Is this a pyo?

Robin Grimmer — Thu, 17 May 2012 13:44:59 GMT

The BAST was normal. I'm seeing her this evening - probably get her in for spay tomorrow and have a look at the liver.

Re: Is this a pyo?

Martin Atkinson — Thu, 17 May 2012 09:13:50 GMT

I would be worried that there was a liver problem and a blood clotting defect so would want a clotting profile and look for lungworm) before I did an ex. lap. Last one I had like this turned out the source of bleeding was an intra-pelvic vaginal tumour almost invisible to any form of investigation. Also had one that was bleeding from the canine equivalent of fibroids in the uterus, again invisible to imaging at the time and it had a blood clotting problem, 'twas a long time ago and I never found the exact cause. Best of luck.

Re: Is this a pyo?

james herriot lied — Thu, 17 May 2012 00:37:12 GMT

[quote user="Robin Grimmer"]

Should I just go ahead and spay her anyway?

[/quote]

Yes.

[quote user="Robin Grimmer"]

I have seen some increases in liver enzymes in pyos but nothing this high.

[/quote]

I think you might have, now. The problem is, you have some kind of uterine pathology, with or without liver pathology. You could go down the medical route and use alizin, except that the datasheet reads: 'Do not use in dogs with impaired hepatic or renal function, in diabetic animals or in dogs in poor health', which means that if the liver is affected, you could have some big problems with it. If the liver is simply reacting to the uterus, then the best treatment would be to remove the uterus in any case. And if you spay and find a normal uterus, then not only have you done the dog a generally good deed, but you've also had the opportunity to have a butchers at the liver, and it's right there if you want to take a sample.

I'd most certainly be doing at least a BMBT first, though. Have you had a look around the ovaries, as well?

And, lest Wynne doesn't show up before the morning, have you also considered lungworm?

Re: Is this a pyo?

David Mills — Wed, 16 May 2012 23:24:01 GMT

ALT/ALP are only indicators of liver damage, are very non-specific, and are useless for prognosis. I assume function is unaffected and the dog isn't yellow. In which case you likely have an infectious process causing non-specific liver enzyme increase; you may not have seen liver figures so raised in pyos before but you may have sampled at a different point in the disease course in the past. We see 2-3 pyos a day pretty much and have recently stopped blood sampling them pre-surgery because it doesn't change our pre-op management (debatable point about pre-GA BS ever changing management). Sounds like an open one. Another vote for getting on and spaying; much sicker dogs go through longer GAs for liver biopsies when their livers are shot to shit and wake up fine; these figures wouldn't bother me at all; what is a liver US going to tell you in an old dog without some sort of sampling?

Re: Is this a pyo?

Michael Woodhouse — Wed, 16 May 2012 22:08:23 GMT

Open her up, spay her and LOOK at liver.

Re: Is this a pyo?

James Laidlaw — Wed, 16 May 2012 19:19:10 GMT

X2 for having a qck scan of the liver (if haven't already) or a proper scan if time and cost and skills permit? Also could do a quick smear of the discharge and look for toxic neutrophils/pus with diff quick.

Re: Is this a pyo?

Julian Earl — Wed, 16 May 2012 18:27:36 GMT

I don't think you can ignore the vaginal discharge. A case for Alizin while you try and sort out the liver?

Re: Is this a pyo?

Sarah Keir — Wed, 16 May 2012 17:41:56 GMT

I would be worried with low uea and high liver enzymes - may be that liver isn't working well. How about Albumin levels?

Re: Is this a pyo?

HMC — Wed, 16 May 2012 17:39:43 GMT

Did you scan the liver too?

Re: Is this a pyo?

Hannah Wynne Richards — Wed, 16 May 2012 17:22:11 GMT

I think you've got 2 problems A mild pyo superimposed on a liver problem

Wynne