I asked:
"Does he go to the Bishan
Dog Park and dig the
soil and eat grass and lick
soil?"
Yes," she said. "He loves to
do that when we take off the
lease at the park."
"Why do you bring her to the
Bishan Dog Park since you
live in Punggol?"
"The Bishan Dog Park is the
place where the dog can run
around without a lease," she
replied.
"Any construction nearby?"
Dr Daniel asked.
"Yes," she said. There are
new HDB flats being built in
this pretty new town with
waterfronting views, so
there was dust all around.
"The soil bacteria could
have gone into the eyes,
nose and mouth and then the
submandibular lymph nodes,"
I said. " A blood test will
be important to help in the
diagnosis." I got
permission for a blood test.
BLOOD TEST RESULTS -
Significant findings were:
Total white cell count
17.4 (6-17)
N=71%, L=23%, M=6%,
E=0.2%, B=0.6%
Urea 10.5
(4.2-6.3)
Use evidence-based medicine
to come to a diagnosis if
the owner can afford the
blood test as it tells a lot
of causes but the vet must
know how to interpret them
in relation to the clinical
signs. In this case,
glanders was confirmed by
the increase in total white
cell count in the blood test
as a result of a systemic
bacterial infection.
What is the significance of
increase in monocytes? This
could mean a long-standing
chronic infection and well,
this young dog had an active
outdoor digging and eating
soil and so, the infection
from the soil had been going
on for some months. Hence,
an increase in monocytes.
Based on clinical signs,
blood test helps in coming
to a correct diagnosis of
"glanders". The owner would
know simply that her dog had
a bacterial infection.
I tried phoning the owner
again to close the case by
giving her the blood test
results. As I typed, the
happy owner phoned me and
said that the dog was still
eating and drinking as
before and had the following
improvements as compared to
2 days before treatment
"Both eyes are still tearing
but much less," she said.
"No more redness in the
eyes." She was
referring to the acute
conjunctivitis which she saw
when I pulled down the eye
lids.
"How about the size of the
submandibular lymph nodes?"
I asked.
"I don't know whether it is
psychological but I feel
them as being much smaller
than on that day."
"You are correct in finding
that the size had gone down
considerably due to
the injection," I said.
"Continue the antibiotics
and change his life-style".
So, no more soil digging and
eating grass for the active
pet as the soil bacteria had
infected her.
P.S The owner got the dog
treated early and so the
total white cell count had
not reached a much higher
level and the young dog was
still eating and drinking.
The submandibular lymph
nodes could have expanded
bigger and ulcerate.
The owner was worried about
the dog having pus in both
eyes for the last 4 days and
made an appointment to see
me. The bacteria had gone to
the eyes as well but
antibiotics and
anti-inflammatory injections
I gave had nipped the
infection in the bud. So,
the owner was happy with the
recovery when I phoned 2
days later. This was good
news for everyone. Except
for the Schnauzer as he has
to change his free soil
digging and eating
life-style.
P.S "Glanders" is more a
disease of horses in the
older days. It is rare to
get a case in the young
Singapore dogs and puppies
nowadays as the standard of
hygiene is much higher in
Singapore kennels. I
remember my professor's
lecture about this disease
and that was in 1973 as a
final year vet
undergraduate. I did see a
few puppy cases from
breeders some years ago but
no more. This is not
just a case of acute
conjunctivitis. Just
prescribing some eye drops
will not help to resolve the
problem.
P.S It is best to follow up
on the owner 2 days and do a
blood test. |