I have a 20 month old Japanese Chin girl. I got her last August

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I have a 20 month old Japanese Chin girl. I got her last August and took her in for routine bloodwork. My vet said she seemed really healthy but her WBC was slightly elevated, about 17,600. She had me bring her in again in 2 weeks for re-testing. WBC was then about 16,700. some of her other numbers were also elevated. Xhe x-rayed her, said one uterine horn looked a bit prominent on x-ray, didn’t think she had pyo. Chin was highly energetic, voracious eater. Vet was puzzled, didn’t give meds but said if she stopped eating or got lethargic, bring her back. I thought if she wasn’t concerned, I shouldn’t be either.

Chin was bred in November. In early December, took her to new vet who thought she was carrying 5 pups. I mentioned the slightly elevated WBC and asked him to run a CBC panel. Her WBC came back at 26,000. My vet was alarmed, thought the pups were most likely dead, ultrasounded her and found 5 healthy heartbeats. Immediately put her on amoxy. In a week, her WBC was 23,000. Kept her on amoxy. Chin remained energetic and great eater all through pregnancy, although she also continued with slight bloody discharge. Was going to have her ultrasounded on the 59th day, but she delivered on the 57th day. First two pups died, third had weak heartbeat - vet gave atropine but pup died. fourth pup was fine, fifth also needed atropine but made it. Immediately put her on clavamox. WBC came down to 10,000. Asked vet to do culture -- came back showing E. coli - put her on Cefa for 10 days. One pup got diarrhea, so took her off meds. WBC climbed back up to 17,000. Pups are now 6 weeks, probably can be weaned off in a week. Mother still energetic and eating, but still has slight bloody discharge -- never stopped since the November heat.

Haven’t tested her in the last 3 weeks -- waiting for pups to wean. What could be going on with my girl???? I’d like to breed her again, but only if she can get healthy. Any clues?

Customer (name blocked for privacy)

Status: Closed Value: $10

A couple of things...

1. No part of a NORMAL uterus is visible on an xray...If there is visible presence of enlargement of any part of uterus...that needs to be investigated.

2. Elevation in WBC needs to be further investigate in that there are are several white cells that make up the WBC...neutrophils, lymphocytes, etc. What were those numbers?

3. You need to have this dog now ultrasounded with a non-gravid (pregnant) uterus...to determine the problem. I think that your dog's problem is in the uterus and the cause of the puppy death (probably from the infected horn) and early delivery.

The probably only reason you dog has not become significantly sick (my guess) is the infection/inflammation may only be in one aspect of the reproductive tract...ovarian/horn and that it is an "open" infection which means the cervix is staying paritally open so the discharge comes out versus staying stuck in the uterus and making the dog more sick.

Anyway, these are my thoughts with the information you gave me. Let me know if you have further questions.

Dr.V

Edited by DanaDVM on March 4 2005 at 11:40 PM

Dr. D.A. Vamvakias
Veterinarian

Reply to Dr. Vamvakias's Post: Hi. Thanks for your quick reponse. I don't have the numbers with me but I do know that her neutrophils, lymphocytes, etc. were all higher than they should be.

That definitely makes sense that perhaps one horn is infected. If so, that's quite a while for the infection to be festering in there. I will take her tomorrow to be ultrasounded. If this is the problem, is it something that can be treated successfully with antibiotics? I'd hate to have her spayed but it's more important that she be healthy.

I assumed that the first two puppies had died inside her triggering early delivery. She was alone for about half an hour when she started delivering, so I don't know if the first two were born alive or dead -- she had cleaned them up but they were cold.

Do you think this might be pyo? Or something else? I feel so bad for her because I know something is wrong, but she's so cheery and happy and active. She appears the picture of health, but I know there's a major problem.

Thank you.

It is a tough call, but pyometra is obviously inflammation/pus in the uterus...but the underlying cause is the concern. She may have a structural defect or pocketing in that horn that is sequestering inflammation...

The time line doesn't fit...but she is young and has a healthy immune system so maybe there is a pocket and the body is able to control it, I am not sure.

Treatment...if you are definately wanting to breed the dog, they can go in and surgically expose the uterus and lavage(rinse it out) and infuse with antibiotics and keep the dog on antibiotics and see how it goes. You can go in under sedation and try to do this without surgery...if the cervix is open.

I think the first thing is ultrasound and a close look at each horn/ovary and the normal kidney structure.

Let me know how it goes!

Dr.V

Dr. D.A. Vamvakias
Veterinarian

Thank you so much. I'll definitely let you know.

Have a great night. ;)

Alice

Your welcome.

Dr.V

Dr. D.A. Vamvakias
Veterinarian

Reply to Dr. Vamvakias's Post: Hi Dr. V.,

Sachiko is at my vet's now. He ultrasounded and x-rayed her. Her right uterine horn is still enlarged, while the left has contracted. He's going to try to insert a catheter and flush her out with saline and then infuse her with batril.

Do you have any other suggestions?

Alice

I would say if he hasn't inserted the antibiotics...I would place a sterile catheter in with warm sterile saline and push in then out a couple times...then take out the saline and have it analyzed for both cytology and culture and sensitivity. If he has already done it...then it is awaiting game to see if the inflammation goes down.

Dr.V

Dr. D.A. Vamvakias
Veterinarian

Reply to Dr. Vamvakias's Post: Hi Dr. V.,

My vet said there was no pus, but there was bloody discharge. I had asked him to do another culture and more bloodwork. He said he is doing culture and sensitivity. Not cytology -- I don't recall what he said about why he's not doing that.

He said the bloody discharge was still coming out from the birth. Shouldn't that have stopped by now? I wanted her to get a shot of oxytocin after she delivered, but the emergency vet said that her calcium level was good so they felt she didn't need it. my vet had run out of it. Could that have helped clean all this bloody discharge out?

I know it wouldn't have resolved the infection issue, but would that have at least stopped all the oozing?

Alice

I would think since that side is abnormal for "unknown" reason that there still may be tissue in there that is bleeding...the other side is probably good. They can "bleed" for a month or so.

Oxytocin is okay for uterine contractions...I am concerned about that side, and I don't know if oxytocin would make that a big difference.

Dr.V

Dr. D.A. Vamvakias
Veterinarian

Reply to Dr. Vamvakias's Post: Well, if she's not feeling better in a few weeks, I might just have to fly to Kansas to have you treat her.

Thank you again.

Alice

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Elevated WBC, slight bloody discharge since November heat

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