Boston Terrier Bleeding from Penis but urinating normally

RE: Boston Terrier Bleeding from Penis but urinating normally

Anthony Dennison — Mon, 25 Sep 2017 12:44:47 GMT

He was referred to Liverpool SATH on Friday by my colleague. Will let you know what happens.

RE: Boston Terrier Bleeding from Penis but urinating normally

Tim Browning — Mon, 25 Sep 2017 09:49:30 GMT

Make sure lung worm not involved, may be more likely than TVT!

RE: Boston Terrier Bleeding from Penis but urinating normally

Anthony Dennison — Mon, 25 Sep 2017 09:12:27 GMT

[quote user="Andrew Kent"]

How were the coags measured in-house or external? If in-house which analyser do you use?

It is relatively uncommon to see PTT elevations with normal PT - the most common cause is a spurious lab result either due to an incorrect ratio of citrate to blood or with certain analysers (this is a known fault with the Idexx coag DX for example).

[/quote]

It was done in house using the coag dx machine, bloods run within 5 minutes of sampling, it was double checked and was correct.

RE: Boston Terrier Bleeding from Penis but urinating normally

Andrew Kent — Fri, 22 Sep 2017 21:43:02 GMT

Hi Anthony,

How were the coags measured in-house or external? If in-house which analyser do you use?

So I would check that again, perhaps externally, before starting any factor assays.

If its true then your plan sounds good - if not then cystoscopy could be useful to more accurately define the location of bleeding - although that may not be possible in such a small dog breed so you may have to rely on your retrograde study.

Andy

RE: Boston Terrier Bleeding from Penis but urinating normally

Michael Woodhouse — Fri, 22 Sep 2017 21:31:48 GMT

Just sense check your 10% decrease in PCV with a manual PCV.

RE: Boston Terrier Bleeding from Penis but urinating normally

Emily Rainbow — Fri, 22 Sep 2017 21:29:04 GMT

AngioSNAP?

RE: Boston Terrier Bleeding from Penis but urinating normally

Lindsey Edwards — Fri, 22 Sep 2017 20:15:57 GMT

steer clear of surgery/invasive procedures? Trenaxamic acid once bloods drawn for clotting, suprelorin/ypozane to help address prostatic enlargement. Doxycycline if prostatic infection/history of pyrexia - very young for BPH?

RE: Boston Terrier Bleeding from Penis but urinating normally

Anthony Dennison — Fri, 22 Sep 2017 15:15:44 GMT

Well then, this has got interesting...

Bloods yesterday showed a mild anaemia (PCV 36.8%) with a very slight increase in absolute reticulocyte count (168.8, upper ref range 110).

Slight reduction in TP (49, lower ref range 52) likely due to a hypoglobulinaemia (24, lower ref range 25). Slightly low cholesterol too, just below normal.

Urea was 10.4.

Today, coagulation screen was done and apTT was >300 seconds. PT 14 seconds. PCV has dropped to 26.5% and absolute reticulocyte count has increased a tiny amount to 179.5. A very mild neutrophilia is also present. Isn't a 10% drop in PCV overnight pretty significant?

No other signs of bleeding elsewhere as far as I know. No petechiae or ecchymoses. An elevated apTT would mean an issue with the intrinsic clotting pathway, so could be haemophilia, or Von Willebrands.

I've suggested further bloods to check for factor VIII and Von Willebrands disease, as well as repeating the abdominal scan to check for any other signs of bleeding.

Any further ideas?

RE: Boston Terrier Bleeding from Penis but urinating normally

Clive Ansell — Fri, 22 Sep 2017 12:47:07 GMT

Maybe urine or prostatic wash for analysis and C&S

and/or Ypozane, and castration.

RE: Boston Terrier Bleeding from Penis but urinating normally

Anthony Dennison — Fri, 22 Sep 2017 11:25:30 GMT

[quote user="Gerry Polton"]

Hopefully hasn't been overseas to TVT endemic areas?

Gerry

[/quote]

Not that I'm aware of, but will check into it.

RE: Boston Terrier Bleeding from Penis but urinating normally

Gerry Polton — Fri, 22 Sep 2017 11:04:17 GMT

Hopefully hasn't been overseas to TVT endemic areas?

Gerry

RE: Boston Terrier Bleeding from Penis but urinating normally

Nicola Cole — Fri, 22 Sep 2017 10:55:03 GMT

Presumably checked penis/prepuce for lesions? Is young but if prostate palpably enlarged I would normally give tardak and if resolves with that just go ahead and castrate. If poorly responsive to tardak then I would investigate further.