Icteric 9 week old FE Sprocker, thoughts?

RE: Icteric 9 week old FE Sprocker, thoughts?

Bob Russell — Thu, 22 Dec 2016 15:24:59 GMT

OP states unvaccinated so that part is a tangent.

A local training group was discussing L4 vaccination pros/cons. I suggested rather than discussing it endlessly amongst themselves and believing Google, they should talk to someone that had the slightest clue about the subject i.e. me!

RE: Icteric 9 week old FE Sprocker, thoughts?

Aine Seavers — Thu, 22 Dec 2016 00:02:01 GMT

[quote user="Martin Atkinson"]springer spaniel with IMTP, not IMHA, which[/quote]

Note the spaniel breed and hence might find this paper interesting

Vaccidents and adversomics; Vaccine 28 (2010) 6549–6550

genomic adversomics will mean that we can one day pick the vaccidents dogs and humans well in advance. Would be interesting to know how the rest of the litter went as in humans often only one child in the family gets the TP effect. TP is a known effect of vaccination in children but interestingly is no longer a reason to stop vaccinating the child later on in life. The vaccine does interfere with platelets and one of the reasons why since 1985 paper below, I personally dont like to do surgery elective within one month of a vaccine or give carthrophen concurrently etc.

Acquired bleeding disorders in the dog- JSAP June 1985.

But for this sprocker I would be going with Wynne and looking for infectious cases, toxins and other triggers not the vaccine.

RE: Icteric 9 week old FE Sprocker, thoughts?

Aine Seavers — Wed, 21 Dec 2016 23:51:41 GMT

[quote user="Will McMullan"]

secondary to vaccination?

[/quote]

proven not to be.

we used to see a lot more AIHA post vaccination up to the end of the 1990s. Most had had a concurrent flea problem which was addressed at the visit by some via administration of an organophosphate product (also not a good thing to be giving generally!). My reading was that organophosphate inhibition of pancreatic BuChe leads to cholinergic hyperstimulation of the acinar cell, which results in acute pancreatitis in dogs and guinea pigs. Pancreatitis is known to trigger IMHA? So were many of the earlier vaccine reported AIHA actually from co-administered chemical? the combination of both or a genetic based immune condition in some lines of some breeds esp C.Spaniels?

I found an old snippet note below, from 2010 so may have been replaced by more current publications but a good read on fears, misinformation and true risks related to vaccination

Vaccination⁹ has been a purported cause of IMHA in dogs, in spite of its rarity in cats and humans. This possible association was suggested by a case-control study in which 15 of 58 IMHA cases (26%) had been vaccinated in the previous 30 days compared with 5% of the 70 control dogs. The second highest rate was among dogs (13 of 58) that were vaccinated more than 12 months before IMHA diagnosis. This association was not supported by a later case-control study which found no significant difference between groups. Five (10%) of 52 cases had been vaccinated in the month before diagnosis, as had an equal number of control dogs. The largest number (17) of cases had been vaccinated 12 months or more before diagnosis,compared with 5 controls. Other investigators also failed to find an association between vaccination and IMHA using a case-control study.

References

Adverse events diagnosed within 3 days of vaccine administration in dogs- Moore et al JAVMA Oct 2005

3) Acquired bleeding disorders in the dog- JSAP June 1985.

4) Treatment of CNS Inflammatory Disease (GME) in Dogs; CVE Pharmacology 2008: Dec 6-7^th

5) Effects of insecticide, diazinon, on pancreas of dog, cat and guinea pig-Frick TW et al; J Environ Pathol Toxicol Oncol.1987 Mar-Apr; 7 (4):1-11

6) Vaccination Protocols for Companion Animals: The Veterinarian’s Perspective- Horzinek MC J Comp Path 2010 Vol 142-129-132

7)Effects of Ageing on the Immune Response of Dogs to Vaccines- HogenEsch- Thompson- J Comp Path 2010 Vol 142;74-77

Masini E, Di Bello MG, Raspanti S, Fomusi Ndisang J, Baronti R, Cappugi P, Mannaioni PF. The role of histamine in platelet aggregation by physiological and immunological stimuli. Inflamm Res 1998 May; 47(5):211-2

8)VCNA SAP Adverse Vaccinal Events in Dogs and Cats George E. Moore, DVM, MS, PhD*, Harm HogenEsch, DVM, PhD. Pg 393-408.

9) VCNA SAP Vaccine in Veterinary Medicine- a brief review of history and technology Scott McVey, DVM, PhDa,*, Jishu Shi, DVM, PhD pg 381-393

10)Bordetella Bronchiseptica has zoonotic potential- Professor Richard Ford-Topics in Veterinary Medicine 1995 Vol 6 ;3:18-22

11) Edwards DS, Henley WE, Ely ER, Wood JL. (2004) Vaccination and ill-health in dogs: a lack of temporal association and evidence of equivalence. Vaccine -22 (25-26): 3270

RE: Icteric 9 week old FE Sprocker, thoughts?

Martin Atkinson — Wed, 21 Dec 2016 14:16:23 GMT

[quote user="Bob Russell"]I was under the impression that old chestnut had been put to bed (vaccination link)![/quote]I had a springer spaniel with IMTP, not IMHA, which presented 2 weeks following booster vaccination. I treated it with Vinblastine and preds and it made a full recovery within a couple of weeks. Very suspicious the vaccine was the trigger.

[quote user="Bob Russell"]Think it was Zoetis CPD that suggested spaniel IMHA is genetic and just as common in unvaccinated dogs.[/quote]Well they would wouldn't they? They're hardly likely to admit it. And it was Pfizer vaccine I was using as well!

RE: Icteric 9 week old FE Sprocker, thoughts?

Bob Russell — Wed, 21 Dec 2016 14:00:16 GMT

I was under the impression that old chestnut had been put to bed (vaccination link)!

Think it was Zoetis CPD that suggested spaniel IMHA is genetic and just as common in unvaccinated dogs. Don't have a reference!

RE: Icteric 9 week old FE Sprocker, thoughts?

Will McMullan — Wed, 21 Dec 2016 12:59:46 GMT

secondary to vaccination?

RE: Icteric 9 week old FE Sprocker, thoughts?

Andrew Kent — Wed, 21 Dec 2016 11:21:38 GMT

True primary IMHA is almost unheard of in dogs of less than about 6 months so it would be very low down my list at 9 weeks and if haemolysis really seems to be a feature would consider other causes (infectious, toxic, secondary IMHA) first.

Andy

RE: Icteric 9 week old FE Sprocker, thoughts?

Martin Atkinson — Wed, 21 Dec 2016 11:13:52 GMT

[quote user="Neil Wheadon"]

[quote user="David Mills"]Sounds like IMHA[/quote]

Dopey question, but I specialise in these.

What triggers the IMHA in such a young puppy? It wouldn't have been my first thought

Neil

[/quote]No such thing as a dopey question, only a dopey answer - and I specialise in those!

So here goes: parasitic burden?

RE: Icteric 9 week old FE Sprocker, thoughts?

Neil Wheadon — Wed, 21 Dec 2016 09:34:41 GMT

[quote user="David Mills"]Sounds like IMHA[/quote]

Dopey question, but I specialise in these.

What triggers the IMHA in such a young puppy? It wouldn't have been my first thought

Neil

RE: Icteric 9 week old FE Sprocker, thoughts?

Michael Woodhouse — Tue, 20 Dec 2016 22:22:22 GMT

We had a similar sounding ESS puppy this week - it's in the freezer now.

Can find out more details from one of the girls who dealt with it if anyone interested.

Seems a bit of a run.

RE: Icteric 9 week old FE Sprocker, thoughts?

E K — Tue, 20 Dec 2016 21:58:10 GMT

Thank you all for your replies, sorry for the delay (got locked out for a while as forgot password!). Unfortunatelyl, the client did not wish for any further treatment/investigations

RE: Icteric 9 week old FE Sprocker, thoughts?

Virginia Campbell — Thu, 08 Sep 2016 17:48:27 GMT

Interesting case, poor pup.

What happened to the sprocker?

RE: Icteric 9 week old FE Sprocker, thoughts?

Richard Carter — Thu, 08 Sep 2016 16:15:34 GMT

so our yellow pup turned out to be chronic renal failure (2 months old!) which uraemia in turn the caused hyperparathyroid metastatic calcium deposits in stomach, gastritis etc apparently the icterus was secondary to bile stasis with fairly mild hepatic pathology - not lepto, not adenovirus, not algae poisoning, not aspergillus

RE: Icteric 9 week old FE Sprocker, thoughts?

grumpyoldman — Mon, 05 Sep 2016 11:32:43 GMT

Probably need more info ,some wormy puppies can look a lot younger , if there is nothing on the smear and platelets look normal maybe worth Angiostrongylus test & coag profile? .

RE: Icteric 9 week old FE Sprocker, thoughts?

Thomas Johnson — Mon, 05 Sep 2016 11:06:31 GMT

[quote user="E K"]

BIOP 7-10d. Reportedly BAR until today. Unvaccinated. No known access to toxins (client quite vague on history though). Coughed/vomited roundworm up earlier today. Unsure if any urine passed today. Flat+++, icteric (gums, skin, sclera) with small haemorrhage L sclera, normothermic, bounding pulse.

ALB 24 (25-44), ALP 549 (20-150), AMY 1711 (200-1200), TBIL 121 (2-10), CA >4 (2.5-8.9), PHOS 3.56 (0.94-2.13), CRE 396 (27-124), TP 50 (54-82). PCV 30%.

[/quote]

I would also be thinking IMHA, and with the haemorrhage in the left sclera I would be a little concerned about IMTP as well, have you looked at a smear to check for platelets?

Are the reference ranges for calcium and phosphate appropriate for a puppy? I would expect both to be significantly higher in a 9 week old pup than in an adult dog.

RE: Icteric 9 week old FE Sprocker, thoughts?

Jo Dyer — Mon, 05 Sep 2016 09:48:58 GMT

Have the owners given paracetamol?

RE: Icteric 9 week old FE Sprocker, thoughts?

Richard Carter — Mon, 05 Sep 2016 09:35:55 GMT

Our case also has hypercalcaemia but then is puppy with ARF?

RE: Icteric 9 week old FE Sprocker, thoughts?

Richard Carter — Mon, 05 Sep 2016 09:31:10 GMT

we have same yellow case!! 2month old bulldog unvacc, was given underdose of drontal puppy - enough for 2kg pup, weighs 12kg. Vomiting up and passing roundworms.

Pup fairly alert so is toxic not septic, yellow as anything, Dx at present is a hepatic/ posthepatic icterus with bilirubin, liver enzymes all very high but the bilirubin has now caused ARF as well with massive nephritis and anuria. Blood smear/ WBCC for such a yellow dog unremarkable.

We are considering whether a roundworm is in the bile duct as seen with pigs after worming - anyone seen anything similar? Other possibility is toxic reaction from toxocara?

Reluctent to ga such an obviously unwell pup but may have to try see if can examine/ flush the bile duct open if doesn't show some response to fluids, frus, metoclop, abs.

Anyone still seeing infectious canine hepatitis?

RE: Icteric 9 week old FE Sprocker, thoughts?

Hannah Wynne Richards — Mon, 05 Sep 2016 08:21:15 GMT

If onset sudden, then unlikely to be a shunt. Barrier nurse until proven not to be lepto, and give it antibiotics.

Wynne

RE: Icteric 9 week old FE Sprocker, thoughts?

Emily Rainbow — Mon, 05 Sep 2016 02:51:14 GMT

Ditto david re: checking a smear.

is it a normal size for its age - thinking shunt too?

RE: Icteric 9 week old FE Sprocker, thoughts?

David Mills — Mon, 05 Sep 2016 00:15:38 GMT

Sounds like IMHA. Could also be a bleed with low protein.

Have you look at a smear (spherocytes) or a saline agglutination test?

PCV may be artificially high as likely some dehydration present with that creatinine.