Difficult case!

RE: Difficult case!

scatty — Thu, 06 Oct 2016 23:21:33 GMT

Hi Silvia,

I believe she is doing very well. She is urinating normally again now. The wound looks a lot better, still getting some bloody discharge from the vulva. I am now looking at photos of the wound on email rather than seeing her back in the practice as regularly as she is such a difficult customer (being quite aggressive in the vets).

Anna

RE: Difficult case!

Silvia Maldonado — Mon, 03 Oct 2016 23:21:12 GMT

Quite interesting. Any more news? How's she doing?

RE: Difficult case!

grumpyoldman — Sat, 01 Oct 2016 20:34:42 GMT

Sometimes the Xs Insulin related GH causes an unstable DM that disappears when you spay them.

RE: Difficult case!

Jenny Harris — Sat, 01 Oct 2016 16:49:09 GMT

Yes entire female dogs can get it due to endogenous progesterone causing mammary glands to produce GH. Don't think they necessarily always develop DM

RE: Difficult case!

scatty — Sat, 01 Oct 2016 15:18:24 GMT

Client phoned and m/cam sorted. Thanks everyone I will keep you posted on how she does! Now off for the rest of weekend :)

RE: Difficult case!

Robin Grimmer — Sat, 01 Oct 2016 13:33:53 GMT

[quote user="grumpyoldman"]

Acromegaly ?

[/quote]

Do dogs get acromegaly? And if they did would they not also be diabetic?

RE: Difficult case!

Bob Russell — Sat, 01 Oct 2016 10:52:46 GMT

Tramadol can be great in dogs, just not every dog.

I would not rely on it for post-op analgesia so if in doubt would probably go for one of the newer NSAI's and monitor.

Absolutely not evidence based but I think Previcox works better than Onsior but happily use either.

RE: Difficult case!

David Mills — Sat, 01 Oct 2016 09:50:06 GMT

[quote user="scatty"]I know NSAIDs are c/i in bleeding disorders.[/quote]

Treat the patient not the (incomplete, based on surrogate outcome) theory. NSAIDS aren't going to push your dog into a clotting crisis.

It may be that you're overthinking this case. Think the dog needs analgesia, it's already on abx, and this will sort out most bladder/urinary issues (if there are any). If still incontinent after this, treat the incontinence.

RE: Difficult case!

Clive Ansell — Sat, 01 Oct 2016 09:12:58 GMT

I would throw in a good full dose of a NSAID, and maybe submit urine for full analysis including C&S and microscopy.

RE: Difficult case!

scatty — Sat, 01 Oct 2016 07:49:26 GMT

Acromegaly? - interesting thought. I forgot to say she did have an incidentally hypoglycaemic blood glucose reading when she was starved for surgery but that appears to have gone back to normal now.

I know NSAIDs are c/i in bleeding disorders. I think if she had a large bleed by day 3-4 she woudn't be as bright as she is and there would be lots of fluid in the abdomen but it still concerns me she has some ooze around the wound?! (She isn't hospitalised due to her nature , owner has taken her home but I will call him again today).

RE: Difficult case!

grumpyoldman — Sat, 01 Oct 2016 00:47:54 GMT

Acromegaly ?

RE: Difficult case!

Michael Woodhouse — Sat, 01 Oct 2016 00:02:56 GMT

[quote user="Braden Collins"]With that SG urine I would give her some NSAIDs to see if it helps. I think she may just be painful. [/quote]

Same thoughts I am having. Tramadol thought not to be that great in dogs - we basically have a dog with no or little analgesia on board. Chuck some Pardale V in too.

RE: Difficult case!

Braden Collins — Fri, 30 Sep 2016 23:56:44 GMT

With that SG urine I would give her some NSAIDs to see if it helps. I think she may just be painful.