Sick and vets are stumped! - Page 2

Thanks everyone for the replies. Ill try to answer as best i can. Im in the U.S., yes money is tight but Ill pay whatever is needed to fix this baby and the vet knew that from the begining. The vet agreed she needs x rays but said the infection and fever were more serious and we needed to concentrate on that then we can go to the next step. Unfortunitly it cost me my whole check just for that first appt so i cant possibly afford to have her seen again right away by a different vet. I did a lot of reading last night and I agree she doesnt have enough symptoms to seem like Pyro. i know she has a protein deffency and read that there are only 4 things that can cause that. Her urine is bright yellow so Im sure its Kidneys or maybe bladder infection. But why would her belly be so big? And not be sensitive at all? She has ate chicken and eggs but there is deffinitly already damage to her muscle's due to lack of protein. I know she should lose some weight due to not eating but not like she has. Poor girl is skin and bones all but that big belly. She hasnt had her first heat that i can tell...no bleeding, swelling, or behavior to say she was in heat anyway. Im at a loss now i feel like the vet didnt do all that she should have. O and as far as internal bleeding Im told blood work will tell you if thats happening. I get paid again Friday, should I see a different vet?

Also the vet said we are probably lookin at surgery but she couldnt even try to do it till whatever infection she has is gone or better, is that true? This was her reason for not going ahead with x rays or anything else for now.

Shortness, while 7 months of age is on the young side for a bitch to have had her first heat, it is NOT all that uncommon; it is also not uncommon for females to have what are referred to as 'silent' or 'split' heat cycles, during which you wouldn't necessarily see any discharge or obvious change to the external tissue of the vulva...so it is perfectly possible that your dog HAS gone through a partial heat cycle within that past two to four weeks, unbeknownst to you (and you wouldn't be the first person that happened to, so don't feel badly).  I'm puzzled to some extent as to why you wouldn't think a closed pyometra fit the clinical signs you've described, because aside from the fact that you don't have any evidence that she's gone through any form of an estrus yet, EVERYTHING else you mention fits PERFECTLY with a closed pyometra.  The high fever, the anorexia, the elevated white count, the distended abdomen...they are textbook for closed pyometra, if we err on the side of caution and presume that she DID have at least a partial or silent heat that was missed precisely because of the type of estrus taking place at that time.

And yes, while generally speaking any doctor, human or veterinary, prefers to hold off on any sort of surgery if there's an existing infection in evidence, but in the case of a closed pyometra, said doctor has no option in the matter: without surgery, the dog is going to become systemically septic--the anaerobic bacteria that cause the closed pyometra are multiplying in the uterus and then being carried by the bloodstream to the other body organs, and affect the function of those organs as well; if the uterus ruptures as a result of the closed pyometra, the dog is then dealing with peritonitis as well when the infectious secretions leak out of the uterus and into the abdominal cavity. In the other form of uterine infections, the open pyometra is less likely to cause a systemic sepsis because the pus is being discharged via the vagina, making it less of a risk that the uterus will rupture, and it is possible to treat the condition without surgery, using antibiotic and hormone therapy to destroy the bacterial colony and forcing the uterus to contract to better expel the infectious fluid it contains. 


When you say you know she has a 'protein deficiency', how do come to have this knowledge?  Is this something the vet told you subsequent to the blood testing, or a urinalysis?  The bright yellow color of the urine indicates that it's very concentrated, but with her running such a high fever, her system is unbalanced as far as hydration is concerned, and consequently her body is burning off more fluid than she can presently take in by mouth.  In truth, I'd be more comfortable if her urine was more dilute, because I'd have less concern about her hydration status and her electrolyte balances... You can monitor whether she's dehydrated or not by (1) lifting the loose skin over the nape of the dog's neck with two fingers, so it forms a 'tent', hold it up like that for a few seconds, and then let the skin drop and count how long it takes for the skin to return to the normal position--it should be mere seconds if she's not dehydrated; and (2) lift the dog's upper lip gently and lightly touch the dog's gums; it should feel moist to outright wet, not dry or tacky (sticky) if the dog's hydration is normal. 


If you absolutely, positively CANNOT take this dog in to be seen sooner than Friday, than if nothing else, PLEASE take the dog's temperature every few hours--if it goes up to or stays above 102-103 degrees, then nothing is improving, and waiting until Friday is a risk I wouldn't be willing to take and you'll have to use your best judgement in that case. 

I do understand about budgetary issues, too...probably the majority of the population lives paycheck-to-paycheck, too, but I would hope your vet would be willing to work with you in some manner and take care of the dog before Friday, even though you wouldn't be able to pay until Friday; would they allow you to write them a check, and agree to hold it until Friday?  It's worth asking; all they can do is say, 'no'. 

Another option to consider:  Most vets here in the US now work with CareCredit, a credit card company that's has specific programs for pet owners to use in paying for vet bills--the applications are typically right at the front counter, and most people can be approved for at least the cost of the impending procedure right on the spot, even if they have poor credit. There's usually an interest-free for xxx number of months promotional offer running, although it is IMPERATIVE that the monthly minimum payment be made each month in order to receive the interest-free benefit--if you're late with even one payment, the full interest on the original total of the bill will be charged, with no excuses or exceptions considered.

Good luck to you and your Heeler girl...here's hoping that she hangs in there and starts improving, and that everything works out well for all parties involved.

 

I cant remember now what I read that made me think her symptoms didnt all seem like Pyro but either way I wont argue with so amny people with the same idea. The vet did tell us she didnt have enough protein. She sent me home with the blood test and I lookied up some of the things that were low and it was in Kidneys and Uterous I believe. One is ALB and its at the lowest end of the scale. The other is PHOS and its at the highest end of the scale. I have decided to see a different vet in the morning (I got a loan to do so). I just pray we can do something soon. Gabby is perking up a bit today. Her fever has almost completly broke and she is loving the chicken, rice, and eggs. I havnt let her have too much cous the first time she ate so fast it came right back up. Do you know how much I should be letting her eat this or how often? Her poor belly is still so very big, I just know it has to hurt :(

Gabby has not had any fluid from her vagina, no vomiting at all (minus when she ate the chicked too fast). From what I read it means hers is closed Pyo and basically has to be surgically fixed immediatly. Is there anything I can do tonight to help her? And should I tell the next vet exactly what I think it is? Do you know if surgery is the only option now?

Never mind; wrong thread. 

I googled PHOS (phosphorus) and ALB (albumin). High phosphorus is most often a sign of kidney failure. Low albumin can be a sign of infection, but kidney problems are a possibility too.

So, maybe the vet was NOT so far off the mark.

I also wonder about the enlarged uterus pressing on the ureters/kidneys and causing kidney problems as well. When doing a hysterectomy, the doctor has to be very careful not to damage the ureters, as they are so close to the uterus.

Good to know the antibiotics have kicked in and brought the fever down.

Symptoms of kidney failure:

Signs of uremia are apathy and depression, loss of appetite and weight, a dry haircoat, a brownish discoloration to the surface of the tongue, and an ammonialike odor to the breath. Dogs at this stage may urinate less than normal. Ulcers may arise in the mouth. With the nephrotic syndrome the dog develops ascites and edema. Vomiting, diarrhea, and gastrointestinal bleeding may occur. At the end stages of kidney failure, the dog falls into a coma.
 

What made me think this could be kidney failure were your comments about 'not enough protein'. Protein can't be metabolized very well when a dog has kidney failure, therefore the body takes protein from muscles, and the animal loses muscle mass and becomes very thin. The non-painful swollen abdomen could be ascites (fluid in the abdomen). Being a woman, I'm pretty damn sure closed pyometra would be QUITE painful.


But the bright yellow urine doesn't fit in with the above. Urine would be very dilute if the dog had uremia, unless it were end-stage.

I am beginning to see why the vet is stumped! 

 

I just had a young dog w/high phos. and the vet said it was no big deal (excellent specialist, not regular vet) due to age- bones still growing, and a few other reasons he cited that I can't remember off the top of my head. So, if all that's off is phos., that is not really cause for concern in a 7mo. old. My young one was 10mos. and vet wasn't concerned and said they were normal findings, but many vets don't see them because they don't do routine bloodwork on healthy dogs- they only see them sick and assume higher value is related to the illness at hand.
I sure hope we find out soon what is going on w/this poor girl.

Also, with kidney problems, you'd think that a lot more blood values would we out of whack, such as creatinine, urea and BUN, but the poster doesn't mention those, nor does she mention that an urinalysis was done. Surely the vet would have done at least an R&M analysis if he suspected kidney problems!

To the OP
With closed Pyo? Yes, surgery is the only
option. 

Sorry to say, if it is a closed Pyo and you
wait too long, you won't have to worry about
surgery or anything, she will be dead.