Complications after car accident

[HumanCompanion]

After a complex ligament tear (due to a car accident) surgery, our dog had a fever of 104F for 3-4 days, loss of appetite. Initial blood workup showed band cells, iron deficiency, leukomoid changes and neutrophilic leukocytosis. Second blood test showed no band cells, some improvement in anemia but the rest remained the same. He was put on more oral antibiotics but when fever didn't recede, he was given Ceftriaxone (IV). His pain medication has been tramadol.

He then had bilious vomiting and fresh blood in stool. He's on fluids now.

Vet isn't sure if this is a complication from surgery or if the accident catalyzed another underlying problem. He asked for XRay of the chest and abdomen but those didn't confirm whatever he suspected. He then felt it was pancreatitis (even though the blood in stool was fresh) but tests ruled it out.

Can anyone offer differential diagnosis? Thanks

[hazelrunpack]

Sorry to hear about the troubles your dog is having. Have you considered a second opinion or a specialist?

[HumanCompanion]

Thanks for your reply, hazelrunpack. He seems to be doing better now. He's still passing blood but his other symptoms have improved.

We had consulted another specialist and his differential diagnosis was tick fever which we've been told is quite ridiculous considering Puchi's blood workup. But we've tested for it either way; it was negative. The vet where he was admitted thought it could be pancreatitis, which again is inconsistent with his blood tests and presence of fresh blood in stools. Both vets seem to be a little incompetent. They've stopped IV antibiotics since the blood in stools symptom, and that in and of itself seems to have resulted in substantial improvement. Will report back on Puchi's progress.

[hazelrunpack]

Glad to hear Puchi is feeling better! Are there any theories as to why he's still got blood in his stool? Could it have been some sort of injury incurred in the car accident?

Tick-borne diseases can be tricky, though--it can take weeks before the titers come back positive or abnormalities show in the bloodwork, so a retest a few weeks down the road might not be a bad idea if there's been any exposure to ticks at all.

[Barkingdog]

http://www.petplace.com/article/dogs...eeding-in-dogs


I found this web site not sure if can help or not. I hope your dog feel better soon .

[MaxaLisa]

Originally Posted by HumanCompanion

... Initial blood workup showed band cells, iron deficiency, leukomoid changes and neutrophilic leukocytosis. Second blood test showed no band cells, some improvement in anemia but the rest remained the same. He was put on more oral antibiotics but when fever didn't recede, he was given Ceftriaxone (IV). His pain medication has been tramadol.

He then had bilious vomiting and fresh blood in stool. He's on fluids now.
.....

This, btw, is completely consistent with tick disease. Doxycycline would have been the antibiotic of choice, with ceftriaxone not touching some of the tick diseases that can cause your symptoms.

Ceftriaxone is a cephelosporin (sp??), and those can completely tear up the gut and take months to recover from - good probiotics are a must.

[HumanCompanion]

Originally Posted by hazelrunpack

Glad to hear Puchi is feeling better! Are there any theories as to why he's still got blood in his stool?

Sorry! I wasn't notified of replies. I just came to update the thread with Puchi's progress and I see there have been 3 replies!

The working theory is that he was on too many and much too strong antibiotics. And in keeping with this, Puchi's been recovering along much better after the medications were stopped. And his stools are solid and with only some spotting. We've been told he'll be fine shortly.

Thanks again for your kind words and response

[HumanCompanion]

Originally Posted by Barkingdog

http://www.petplace.com/article/dogs...eeding-in-dogs

Thanks for the link and your kind words, Barkingdog. I'll bookmark it but hopefully won't never have to refer back to it! Puchi is doing better and we're told the bleeding --which has reduced to mild spotting now-- should be resolved shortly.

[HumanCompanion]

Originally Posted by MaxaLisa

This, btw, is completely consistent with tick disease. Doxycycline would have been the antibiotic of choice, with ceftriaxone not touching some of the tick diseases that can cause your symptoms.

Ceftriaxone is a cephelosporin (sp??), and those can completely tear up the gut and take months to recover from - good probiotics are a must.

Ah, I see! The vet treating him felt it was an unrealistic second opinion for some reason. We did take that with a grain of salt considering he suspected pancreatitis to be a potential cause even though the symptom was fresh blood in stools. However when we googled tick diseases and only two symptoms of his seemed to fit and the suggested diagnostic indicators of all blood parameters decreasing was not consistent, and there was no mention about presence of band cells, anemia or leukomoid changes, so we didn't want to cause further misdiagnosis. The vets there were so drug-happy. Any advise on what to look for in the blood results specifically? And would you know if it would resolve with just two doses of ceftriaxone (via IV)? (I don't know what dosage was used but I'll find out and update here) Puchi's been doing better; no fever, solid stools with some spotting.

Thanks for your reply and advise. He has home-made yogurt regularly but we'll start him on a more complete probiotic as well.

Update: Looks like he was put on doxycycline at first but didn't respond, and then they tried ceftriaxone. And he tested negative for tick fever --if there's more than one type of tick fever, I'm not sure which one he was tested for. (Sorry, he's my nephew and I don't live with him, so a lot of this information is secondhand)

[MaxaLisa]

Interesting about the doxy and non-response, I wonder what they were looking at. Sometimes they give steroids at the ame time which mucks things up.

IF he is doing well, and continuing to improve, I might conider just treating with probiotics, and then retesting blood in 3-4 weeks and see how things are doing. I would make ure the blood is sent out to a lab and not done in-house, and I would also make sure you get a copy of all reults (old and new), and look on the new ones for anything out of range, or near the edges of normal, but still normal.

Some of thee infections we don't have tets for, and we just have to monitor the regular bloodwork for signs. Maybe there is something non-tick that caused the problems that responded to the IV meds, but you want to make ure it really did resolve, and isn't just hanging out, waiting to flair up again. Keep a watching for pale gums and or small red dots on the skin. Blood in the stool would be a sign of either a colitis type thing (possibly from the antibiotics), or internal bleeding (hopefully not!).

[HumanCompanion]

Yeah, he was given steroids as well. And he got worse after Ceftriaxone was given via IV; I don't believe he was given any other IV meds. Once the vets heard of the new symptom of blood in stool, they stopped Ceftriaxone.

Thanks for the advise about monitoring and what to look for in blood results and other physical symptoms. Will update the thread if there are any developments.