PUO in labrador with centronuclear myopathy

RE: PUO in labrador with centronuclear myopathy

emma o'connor — Wed, 16 Mar 2016 09:45:18 GMT

It turns out that she had a retroperitoneal abscess. Had surgery on Thursday to drain it and the site was omentalised. I spoke to the owners who are bringing her home today and they report she is still very weak neuromuscularly, so I am unsure yet what the future will bring for her if her centronuclear myopathy is deteriorating.

RE: PUO in labrador with centronuclear myopathy

emma o'connor — Tue, 08 Mar 2016 11:51:37 GMT

Thanks everyone, thought i would update you all. I last saw Mela on Friday where she was still pyrexic but brighter, we started on metronidazole alongside the marbofloxacin, and she was seen the following day by our weekend vets. She was then admitted for fluids and iv abc over the weekend as her temperature was still over 40 and she had stopped eating again. I have come back to work today to have her handed back to me! She has gone for referal this morning as the owners and I are in agreement she needs further diagnostics such as CT and CSF sampling. Will post the outcome.

RE: PUO in labrador with centronuclear myopathy

Andrew Kent — Sat, 05 Mar 2016 08:04:45 GMT

Difficult one - I agree that you really need to be very sure that you have excluded sepsis before going after immune-mediated diseases. Having said that I have seen dogs develop Immune-mediated diseases shortly after neutering and its worth bearing in mind that some dogs with polyarthritis can just present with pyrexia and no notable pain, same for meningitis.

I think I would ideally be getting an abdominal ultrasound to look at any changes that could be directly associated with the surgery. The radiographic signs of aspiration can also sometimes take a few days to appear so you may need to look again there.

If you continue to find nothing and get no response to (potentially broader spectrum of) antibiotics then it may be worth considering joint taps +/- CSF.

Andy

RE: PUO in labrador with centronuclear myopathy

emma o'connor — Fri, 04 Mar 2016 16:01:42 GMT

With the history of spay 2 weeks ago i'm also concerned re sepsis. I wasn't there at the time so didn't see the op or recovery but the history reports some fluid regurgitation on recovery but not a great description. I switched to marbo given that 24h on amoxycillin had no effect on temp. I am looking at adding some anaerobic cover and if she is still pyrexic this afternoon continuing meloxicam.

RE: PUO in labrador with centronuclear myopathy

Lindsey Edwards — Fri, 04 Mar 2016 15:10:46 GMT

Pyrexic with neutrophilia and left shift, dull and inappetant - I'd be most concerned with a septic process. History of regurgitation I don't think marboflox would be my first choice. Add broader cover and continue nsaids?