Case Report: Malamute with Thrombocytopenia
Wednesday, July 10, 2013 at 12:01PM Honorable Mention, Cases/Abstracts
Hailey Harroun, Colorado
Signalment
Kaiyuh
3yr old FS Malamute
120lb
Longmont, CO
Kaiyuh, a 3-year-old female spayed Malmute, presented to her primary care veterinarian for acute onset epistaxis and a two day history of anorexia. Kaiyuh was current on flea, tick and heartworm medicines, and vaccinations. Owners reported no flea or tick problems and were confident that their pets had no access to rodent poison. Kaiyuh’s only travel history was to Wyoming, and her only current medication was phenylpropanolamine for congenital urinary incontinence. Kaiyuh appeared bright and alert upon presentation. Initial differentials for Kaiyuh’s signalment were trauma, foreign body, anticoagulant rodenticide toxicity, neoplasia and fungal granuloma.
Diagnostics
The primary care veterinarian examined a blood smear of Kaiyuh’s epistaxis and radiographed her skull. No apparent abnormalities were found on blood smear, and no trauma, tumor or foreign body was found on the radiographs. The primary care veterinarian was concerned about anticoagulant rodenticide poisoning, and recommended that the owners take Kaiyuh to a nearby emergency hospital in order to evaluate her clotting times. She also sent the owners with an injection of Vitamin K for treatment of the presumptive diagnosis. The owners took Kaiyuh to the emergency hospital, at which point the emergency veterinarians noticed hyphema and large patches of echymotic hemorrhage on her abdomen. In-house testing revealed that all clotting times were normal and that Kaiyuh had profound thrombocytopenia with a platelet count of 29,000. PCV was 49, and serum chemistry values were all normal except for an elevated lipase. Top differentials at this stage of the clinical evaluation were infectious thrombocytopenia (Rickettsia, Ehrlichia, Anaplasma), immune-mediated thrombocytopenia and vaccine-associated thrombocytopenia.