With severe gastrointestinal haemorrhage urea is usually
higher than in this case, but not necessarily so if there is an intestinal
obstruction. The increased ALT could be secondary to hypoxia, or primary
hepatic injury.
Linoleum flooring can be made of many materials including organic materials
or polyvinyl chloride so it would be impossible to assess if any components
could be considered hepatotoxic. The elevation of CK could also be due to
hypoxia or refractory vomiting.
It is therefore considered that from the results in this
case and the presented history of this animal that some degree of gastrointestional
haemorrhage has occurred.
A case by Rohner et al in 2004 presented life threatening
intestinal bleeding in a Bearded Collie. This dog showed acute weakness,
haematemesis, melaena, painful abdomen, pale mucous membranes, haematocrit
of 13% and panhypoproteinemia. This combination of findings similar to the
dog in this case was the manifestation of severe gastrointestinal bleeding.
Case 22, in Feldman et al (2000) also describes blood loss in an
11 year old Beagle from gastrointestinal haemorrhage. The dog was found
to be anaemic with black tar like faeces. Over a period of 3 weeks, iron,
vitamin B12 and three whole-blood transfusions were administered. Total
plasma proteins of 6.4 g/dl (normal value in an 11yr old dog would be
>7.5 g/dl) further substantiated blood loss.
The presence of a few circulating mast cells in this case
is very non-specific and can be seen normally, but may also occur with mast
cell tumours, allergy/hypersensitivity responses as well as in cases of
parasitism. A study performed by McManus in 1999 showed that 95.5% of blood
smears with mast cells detected were from dogs without mast cell tumours.
Interestingly, of these dogs 27% were diagnosed with regenerative anaemia.
The possibility that the dog in this case may have ingested
rat poison must also be considered. Moderate to severe thromobocytopenia
can occur in dogs that have haemorrhage subsequent to ingestion of anticoagulant
rodenticide toxins (Lewis et al, 1997). It would be advisable that
if ingestion is suspected that the clotting times for this animal be checked.
References:
Feldman BF, Zinkl JG, Jain NC, et al. (2000)
Schalm's Veterinary Haematology – 5th Edition. P504-507. Lippincott
Williams & Wilkins Publishing.
Lewis DC, Bruyette DS, Kellerman DL, Smith SA. Thrombocytopenia
in dogs subsequent to anticoagulant rodenticide-induced haemorrhage. J Am
Anim Hosp Assoc 1997;33:417-422.
McManus PM. Frequency and severity of mastocytemia in dogs
with and without mast cell tumors: 120 cases (1995-1997). JAVMA 1999,
Vol 215, No.3:355-57.
Reagan WJ, Sanders TG, DeNicola DB (1998) Veterinary Haematology,
Atlas of Common Domestic Species. Manson Publishing Ltd.
Rohner MM, Glaus TM, Reusch CE. Life threatening intestinal
bleeding in a Bearded Collie associated with a food supplement for horses.
Schweiz Arch Tierheilkd. 2004 Oct;146(10):479-82. |