Spinal Pain and Scleral Haemorrhage

Re: Spinal Pain and Scleral Haemorrhage

Anthony Dennison — Mon, 03 Mar 2014 11:02:15 GMT

No steroids, stayed on amoxyclav and meloxicam as advised on here and by a neurologist from a referral centre.

Re: Spinal Pain and Scleral Haemorrhage

mariette asselbergs — Mon, 03 Mar 2014 10:35:14 GMT

So did you give steroids at all?

Mariette

Re: Spinal Pain and Scleral Haemorrhage

Anthony Dennison — Mon, 03 Mar 2014 10:20:12 GMT

Update:

Lungworm results were negative. The owner wanted to just monitor the dog over the weekend to see how he got on, and if no improvement we were going to refer today.

I've just spoken to the owner and the dog is back to his normal, bouncy self; no more yelping and he is now playing with toys and bullying the other dogs again. Scleral haemorrhage remains but this will take time to resolve, so for now we are just monitoring.

Thanks so much everyone for all your help, lungworm is so rare in my neck of the woods didn't think of it at all!

Re: Spinal Pain and Scleral Haemorrhage

Anthony Dennison — Fri, 28 Feb 2014 12:36:43 GMT

Results back from the lab (still awaiting Angio Detect - no snap tests left at my practice):

Neutrophilia with raised band neutrophils (only just above higher ref range), lymphocytosis, monocytosis, eosinophilia. Platelets WNL.

PT and PTT normal, though PTT was at the longer end of normal ref range of 23.4 (12-24). Fibrinogen raised, but report suggests that is more likely to reflect inflammation.

Comments: Leucogram consistent with active inflammation. Localised foci of inflammation should be clinically sought, further monitoring recommended.

I feel that these results are more suggestive of a possible meningitis - I will wait for the lungworm results but I think the next step would be referral for further work up - MRI? definately a CSF tap (not allowed to do these in my practice currently, am working on it!)

Re: Spinal Pain and Scleral Haemorrhage

Nicola Cole — Thu, 27 Feb 2014 23:05:12 GMT

+1 for lungworm: would be my first thought with scleral haemorrhage and mild hl neuro signs (but am from a lungworm-y area so may be biased!)

Re: Spinal Pain and Scleral Haemorrhage

Anthony Dennison — Thu, 27 Feb 2014 17:15:04 GMT

Sorry about this, can't seem to get them to upload properly! If you right click on the black cross and open in new tab/window they seem to be visible!

(Ed's note. I've fixed this. I think it might have been because you were uploading the files with very, very long file names which confused the system. Best to rename locally (er, ideally removing patient's name from filename), then upload.)

Re: Spinal Pain and Scleral Haemorrhage

Anthony Dennison — Thu, 27 Feb 2014 17:00:56 GMT

Thanks for the advice. I asked the owner to bring the dog back in and I have taken bloods for a coag profile, comprehensive haematology and Angiostrongylus antigen. I also dispensed Milbemax.

Unfortunately one of my branches was broken into just before Christmas and the thieves stole my otoscope/opthalmoscope so have to share one between 2 branches, and sods law dictates it was at my other branch... sigh.

The OOH vet at the weekend took some radiographs, not sure if there is an increased bronchial pattern? Apologies for the quality, they were emailed to us as jpegs.

Re: Spinal Pain and Scleral Haemorrhage

Andrew Kent — Thu, 27 Feb 2014 14:42:20 GMT

Blood pressure would be the other thing to check, hypertension causing vascular episode would be a possible differential. Retinal exam normal?

Andy

Re: Spinal Pain and Scleral Haemorrhage

Utlendigur — Thu, 27 Feb 2014 14:35:47 GMT

+3 for checking for lungworm asap.

Cerebral and conjunctival haemorrhages associated with von Willebrand factor deficiency and canine angiostrongylosis

Journal of Small Animal Practice

Volume 46, Issue 2, pages 75–78, February 2005

Re: Spinal Pain and Scleral Haemorrhage

Laurent Garosi — Thu, 27 Feb 2014 13:05:58 GMT

I would personally check its clotting times (PT, APTT), chest xrays and check for lungworm. If the owner is insured or have the finances to be referred, I would recommend referral if there is no obvious coagulopathy as better than giving steroids blindly + could interfere later on with further diagnostic tests.

Re: Spinal Pain and Scleral Haemorrhage

David Mills — Thu, 27 Feb 2014 13:01:06 GMT

Lungworm?

Re: Spinal Pain and Scleral Haemorrhage

David Mills — Thu, 27 Feb 2014 13:00:59 GMT

Lungworm?