Veterinary

Ask a Vet and Get Your Veterinary Questions Answered.

Ask a Veterinarian,
Get an Answer ASAP!

Veterinary
This answer was rated:

Our baby princess yorkie (4 lbs) started on Wednesday night

with diarrhea, by Thursday morning...
Our baby princess yorkie (4 lbs) started on Wednesday night with diarrhea, by Thursday morning she had diarrhea with blood, so we decided to take it to the Dr. They identified illness-vomiting/diarrhea/GI. They run all the tests on her, and results were negative even fecal for bacterias, pancreatitis, Giardia...everything negative but she still continued with bloody diarrhea. Amylase 357; Bun 32; Eosinophil 0,6%; RBC 9.550; hemoglobin 22; hematocrit 67.210%; MPV 13.3 FL. No evidence of intestinal obstruction. They gave her Cerenia (injectable) 10 mg/ml - 0.03 mL IV; Famotidine (injectable)10 mg/ml - 0.17 mL IV; pyrantel pamoate 50 mg/ml 0.5 mL; IV fluid therapy 16 mL/hr LRS IV; metronidazole (injectable) 5 mg/ml - 1.3 mL IV @ 2 pm and 6 pm. At 7 pm we picked her up, but she was still very week and bloody diarrhea persisted, so they suggested to take her to ER for overnight fluids and care. Upon intake she had at 9:15 pm BG 22 and they gave her 7 ml of 50% dextrose and 7 ml salon admin IV. By 10 Pm her BG was 99, they gave her metronidazole (5 mg/ml) 4.5 ml IV BID; Barium 7 ml per rectum, ondansetron (2 mg/ml) 0.18 ml IV BID, hetastarch 2 ml IV q2 hrs. By 11 pm her BG went down to 29 and they gave her 5 ml of 50% dextrose and 5 ml salon admin IV; bag spiked to10% dextrose, line flushed. By 1 am her BG went up to 89, temp 100.6. By 2 am her BG went down to 49 and they gave her 6 ml of 50% dextrose and 6 ml saline IV. At 3 am more profuse bloody diarrhea came from her rectum, she stopped breathing, they intubated her, did CPR but she didn’t respond and passed away. We want to know for peace of mind what went wrong? For us it seems that medication given at the 1st place was not enough to attack the bacteria on time and let it reproduce the entire day, so when we took her to ER was probably too late. She was the light of our lives, please let us know what do you think happened and if we could have done something better?
JA: I'll do all I can to help. Hopefully it didn't make a mess. Did the Yorkie eat anything unusual?
Customer: No that we know, we went for Xmas to Pennsylvania and she might have had chicken that she stole from another dog food bowl.
JA: What is the Yorkie's name?
Customer: Bella
JA: Is there anything else important you think the Veterinarian should know about Bella?
Customer: She had pancreatitis in the past about 1 year and a half ago, 8 years old, 4 lbs weight
Show More
Show Less
Ask Your Own Veterinary Question
Answered in 17 minutes by:
1/7/2018
Dr. Schmidt
Dr. Schmidt, Veterinarian
Category: Veterinary
Satisfied Customers: 569
Experience: Associate Veterinarian
Verified

Hello, this is Dr. Schmidt. Thank you for using JustAnswer. I am so sorry to hear about your devastating loss. The most striking part of that story is the fact that she did not respond to the IV dextrose. Usually in this type of a scenario, you are looking at a massive infection somewhere, in her case I worry the most about her GI tract, specifically devitalized bowel or a GI perforation or something along those lines. A devitalized bowel or a GI perforation would cause a massive infection in the body and the excess bacteria would eat up the glucose at a fast rate that wouldn't respond to regular treatment. This doesn't always show up on initial bloodwork and xrays. That is the first thing that comes to mind in a dog that went from happy/healthy to what you were describing. It would also explain the vomiting and diarrhea she had leading up to this. The other possibility would be a liver condition that is common in Yorkies called Microvascular dysplasia. It is a liver condition that can cause liver failure. They don't always have elevated liver enzymes with this, but they will often have a hard time controlling their blood sugar and it can spiral out of control quickly sometimes. The other thing I think of with what you're describing would be a tumor in the pancreas called an insulinoma. This is a very tiny tumor that cannot be detected on xray and rarely detected on ultrasound, but it can cause severe drops in blood sugar that are unresponsive to supplementation. I think the most likely thing would be sepsis, likely from the GI tract. I worry about some devitalized bowel being a likely cause, but an autopsy would be the only way to know for sure.

Ask Your Own Veterinary Question
Customer reply replied 13 days ago
Thank you Dr Schmidt. Do you think that the dose of antibiotic given to her within the day was very low considering she wasn’t responding to the treatment? What is the dose of metronidazole that’s usually given in emergency cases?

It is lower than the dose that I usually use in a case like this personally. I also usually add in at least one other antibiotic to give a little better coverage there. They might not have been as worried about an infection in her case because her white blood cell count started off normal, but I have seen these cases start off with normal white blood cell counts and then get a lot worse from there.

Ask Your Own Veterinary Question
Customer reply replied 13 days ago
for all I have been reading that dose seems very low to attack a bacteria. Do you think that the process at the ER with the dextrose and the amounts was the appropriate? By seeing the pattern her glucose took we think that the increase of dextrose given at 2 am shocked her and that’s why she collapsed. What do you think about that part of the process?

The only part of that that was a little strange was the fact that they started her on a 10% dextrose drip, which is a lot higher than usual, but the rest of the protocol is pretty standard to be honest with you.

Ask Your Own Veterinary Question
Customer reply replied 13 days ago
When they run the BG on ER the first time when we arrived it was 22 and they said it was very low and she could have seizures, so they had to increase her levels of sugar and keep her hydrated. For BG at that level what would have you done? Or what would have been the right path to keep her stable?

I would have kept her on a 5% dextrose drip and monitored her blood glucoses every hours and given her a 50% dextrose bolus as needed if her blood glucose got below 60.

Ask Your Own Veterinary Question

But to be honest with you, once they are at that stage, it can be pretty difficult to keep them stable no matter what you do.

Ask Your Own Veterinary Question

It sounds like she was pretty unstable by the time she got to the ER unfortunately.

Ask Your Own Veterinary Question
Customer reply replied 13 days ago
Sorry Dr for so many questions, our heads are just not in the right place right now and we’re trying to understand what really happened. If we’d have taken our baby to you with those symptoms: vomit, bloody diarrhea; what would have you done from A to Z?

I probably would have repeated bloodwork, xrays, and done an ultrasound to try to find out the underlying cause so I could taylor my treatment plan to that. And as far the what specific treatments, it would all depend on what I found on my diagnostics.

Ask Your Own Veterinary Question
Customer reply replied 13 days ago
Understand. In this emergency cases what’s the usual dose of antibiotic (metronidazole) that’s given and what other antibiotic could have been used to reinforce the treatment?
I personally use metronidazole at a 15 mg/kg dose every 12 hours and unasyn at a 30 mg/kg dose every 8 hours and most of the time I will add in Baytril at a 5 mg/kg dose once a day.
Ask Your Own Veterinary Question
Customer reply replied 13 days ago
with these medicines and doses, diarrhea would have stopped and she could have hold her glucose right? Together with the IV fluids.?
It depends on the underlying cause. If she was already septic from devitalized bowel or a GI perforation, by the time she got to the ER, she wouldn't have had a very good chance no matter what antibiotics she was on I'm sorry to say.
Ask Your Own Veterinary Question
Customer reply replied 13 days ago
from everything we’ve discussed, it’s safe to assume my baby would not have been in that condition had she be given the antibiotics you outlined in the doses you described two responses ago. This is so hard

Yes, it definitely is. I understand where you're coming from. It is so awful to lose a pet under any circumstances, much less so unexpectedly.

Ask Your Own Veterinary Question
Customer reply replied 13 days ago
she had an ultrasound two months prior so the tumor isn’t likely. The rest seems right. But you think, in your best opinion that my baby would y have been in that severe condition upon arrival at the 24 hour clinic had she had the antibiotics described above in those doses?
Customer reply replied 13 days ago
Would not have been

Actually, dogs age a lot quicker than we do, so I wouldn't count that out at this point at all. Two months is almost a year to them. Especially an insulinoma which is a very small tumor in the first place. And I really can't say for 100% certain. It might not have made a difference depending on what was the underlying cause. Have you thought about requesting an autopsy to know for sure what happened?

Ask Your Own Veterinary Question
Customer reply replied 13 days ago
I had to go there on Friday to see her. They brought her to me with a towel. I didn’t have the courage at first to lift it, so I started rubbing her legs. Then I lifted the rest. I held her for three hours to warm her. Then I cleaned her face and butt. I gave her a bow, put a warm jacket in her and put her on a bed in her favorite seated position with her head up. I gave her her bone and one of her giraffe toys. She looks beautiful. They put her back in the freezer. I was thinking to dry freeze and preserve her because the hardest thing is taking away the touch of her paws and rubbing her coat. So I guess my question is whether I can do the autopsy and still preserve her. What do you think

I think that if you really want to know what happened to her, an autopsy is the only way to get answers. It might give you some peace of mind to know why this happened. I really can only provide educated guesses unfortunately, but an autopsy would let you know for sure. They can still get some good information even though she has been frozen. I know it won't change anything. Ultimately, it's up to you, but I think it might at least give you some peace of mind. I respect your decision either way, I know how hard it must be for you to be struggling with this.

Ask Your Own Veterinary Question
Customer reply replied 13 days ago
It can I do the autopsy and still preserve her via freeze drying.

I'm not sure about that to be perfectly honest with you. If you ask the ER clinic about that, they can ask whatever pathologist they typically recommend for their autopsies.

Ask Your Own Veterinary Question
Customer reply replied 13 days ago
If this was GI tract infection with devitalized bowel or a GI perforation, and she had received 5% dextrose drip with monitored blood glucoses every hour with 50% dextrose bolus as needed if her blood glucose got below 60, in conjunction with metronidazole at a 15 mg/kg dose every 12 hours and unasyn at a 30 mg/kg dose every 8 hours and Baytril at a 5 mg/kg dose once a day, would she have been critical upon arrival at the ER or would she have been stable and able to receive IV fluid?

She was receiving IV fluids, but the fluid just had dextrose in it. And if she had devitalized bowel or a perforation, she probably would have been critical regardless. I don't think it was anything that the ER or your regular vet did wrong, I think this was just a very serious issue in a very small dog that was too much for her little body to handle.

Ask Your Own Veterinary Question

But again, if you really want answers, get an autopsy done. That is really the only way to know for sure.

Ask Your Own Veterinary Question

I hope that makes sense. I don't think any more speculation is useful or even helpful anymore. It is going to drive you crazy the more you go around and around with this. I would recommend doing the autopsy. Otherwise, it is only speculation. Let me know if you have any more questions, but again, I don't know if I will be able to give you anything definitive in this case. I can only give you my opinion, which isn't by any means fact and won't take the place of autopsy results.

If you have a moment to fill out a positive review (by clicking on the **stars** at the top of the page) for me I would greatly appreciate it. This is the only way the website can credit me for my time. Thank you so much and good luck!

Ask Your Own Veterinary Question
Customer reply replied 13 days ago
What I’m asking is a specific question. If it was the GI tract infection, wouldn’t the more agressive antibiotics have staved off the infection for the fluids to take.

If that was all that was going on, then yes definitely.

Dr. Schmidt
Dr. Schmidt, Veterinarian
Category: Veterinary
Satisfied Customers: 569
Experience: Associate Veterinarian
Verified
Dr. Schmidt and 87 other Veterinary Specialists are ready to help you
Ask your own question now
Ask Dr. Schmidt Your Own Question
Dr. Schmidt
Dr. Schmidt
Dr. Schmidt, Veterinarian
Category: Veterinary
Satisfied Customers: 569
569 Satisfied Customers
Experience: Associate Veterinarian

Dr. Schmidt is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

It was so professional, so personally concerned (as we were) and you answered all of our questions. George and I are so happy that I found "JustAnswer" on my Google search -- you are now in my "Favorites" list! And, yes we do love our kitty - she makes our life complete!

Bev & GeorgeBoca Raton, FL

Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help.

Mary C.Freshfield, Liverpool, UK

This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!!

AlexLos Angeles, CA

Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult.

GPHesperia, CA

I couldn't be more satisfied! This is the site I will always come to when I need a second opinion.

JustinKernersville, NC

Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around.

EstherWoodstock, NY

Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know.

RobinElkton, Maryland

< Previous | Next >

Meet the Experts:

Dr. Andy

Dr. Andy

Medical Director

2,673 satisfied customers

UC Davis graduate, Interests: Dermatology, Internal Medicine, Pain Management

Dr. Bruce

Dr. Bruce

Veterinarian

1,774 satisfied customers

15 years of small animal veterinary medicine

Dr. Gary

Dr. Gary

Veterinarian

1,547 satisfied customers

DVM, Emergency Veterinarian, BS (Physiology)

Dr. Scott

Dr. Scott

Veterinarian

865 satisfied customers

15 years of small animal, equine and pocket pet experience in medicine and surgery.

Dr. Bob

Dr. Bob

Veterinarian

1,323 satisfied customers

35 years in practice

Dr. Drew

Dr. Drew

Veterinarian

1,895 satisfied customers

Small Animal Medicine and Surgery

Dr. Jenn

Dr. Jenn

Veterinarian

1,225 satisfied customers

Practicing small animal medicine since 2004 , also involved in working with animal rescue groups.

< Previous | Next >

Related Veterinary Questions
My 5 yr old yorkies anal glands are infected. She biting her
my 5 yr old yorkies anal glands are infected. She biting her paaws non stop. went to vet he expressed anal glands and gave her a prednisone shot, its not really helping. She keeps scooting too … read more
Dr. Sara
Dr. Sara
Small animal practicioner
Doctoral Degree
93 satisfied customers
I have been waiting since 6:00 pm for a response. Have paid
I have been waiting since 6:00 pm for a response. Have paid $20. and the situation is dire without my questions answered. … read more
divealot1
divealot1
DVM
7 satisfied customers
My hen has a round black crusty area around ear, I think.
My hen has a round black crusty area around ear, I think. Mostly under her eye. She is very steady walking & not rubbing it. I have a picture … read more
Dr. Michael Salkin
Dr. Michael Salkin
Veterinarian
DVM
3 satisfied customers
I have wormed my 5 and a half week old puppies with Drontal
I have wormed my 5 and a half week old puppies with Drontal all wormer syrup, I have lost one pup, the vet had done routine test and there was no par one, but glucose was lo and was also low with prot… read more
Scott Perry
Scott Perry
Veterinarian
Doctor of Veterinary Medicine
1,522 satisfied customers
Our dog asher can not use his back legs. He can not walk
no wound we got xrays and doctor says possibly a nerve pushing against his spine or possibly emolysm … read more
Dr. Kara
Dr. Kara
Doctoral Degree
5,383 satisfied customers
Our dog Taffy is shaking her head. She can't stand still.
Our dog Taffy is shaking her head. She can't stand still. Could you please help us. … read more
Dr. Denise
Dr. Denise
Veterinarian
Doctor of Veterinary Medicine
494 satisfied customers
14 yr old Chiuahuah-Dauschund mix. Head bobs up and down and
14 yr old Chiuahuah-Dauschund mix. Head bobs up and down and walks around the house much of the day and today cries out often. … read more
Dr. Michael Salkin
Dr. Michael Salkin
Veterinarian
DVM
3 satisfied customers
I got a? The ears of my baby well she's a shitzu smells what
Good afternoon I got a ? The ears of my baby well she's a shitzu smells what can I do? … read more
Dr. Meghan Denney
Dr. Meghan Denney
Doctor of Veterinary Medicine
Doctorate of Veterinary Medicine
1,852 satisfied customers
Our 6 month female syrian hamster has a black spot like a
our 6 month female syrian hamster has a black spot like a mole on her skin. no fur loss, but the fur is parted in a circle where the spot is. … read more
Dr. Michael Salkin
Dr. Michael Salkin
Veterinarian
DVM
3 satisfied customers
My rabbit ate half of a Tylenol that was on my floor but i
my rabbit ate half of a Tylenol that was on my floor but i managed to get it from him … read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,175 satisfied customers
My goat licked antizreeze and is acting wierd about a hour
my goat licked antizreeze and is acting wierd about a hour ago … read more
Kelly Jones
Kelly Jones
Doctorate of Veterinary Medicine
248 satisfied customers
My dwarf hamster has a red lump on its bum and he's limping
hi my dwarf hamster has a red lump on its bum and he's limping on his back legs. he also looks like he lost a lot of his weight and seems a lot less energetic than usual … read more
PitRottMommy
PitRottMommy
Veterinary Nurse
Associate Degree
9,175 satisfied customers
Already told you and already paid. Should I start over? My
Already told you and already paid. Should I start over? … read more
Rebecca
Rebecca
Veterinarian
Doctoral Degree
445 satisfied customers
My daughter had dropped her ginnea pig and she thinks it
My daughter had dropped her ginnea pig and she thinks it broke it's leg. … read more
Joan
Joan
Private
355 satisfied customers
I have for the first time three baby canaries, after several
I have for the first time three baby canaries, after several trials the mother seemed to learen the job and both parents have managed to raise the three babies very well...they have about three weeks … read more
Kelly Jones
Kelly Jones
Doctorate of Veterinary Medicine
248 satisfied customers
Our baby princess yorkie (4 lbs) started on Wednesday night
Our baby princess yorkie (4 lbs) started on Wednesday night with diarrhea, by Thursday morning she had diarrhea with blood, so we decided to take it to the Dr. They identified illness-vomiting/diarrhe… read more
Dr. Schmidt
Dr. Schmidt
Veterinarian
569 satisfied customers
I can't tell if my sun conure is sneezing or is just making
I can't tell if my sun conure is sneezing or is just making a sweeking noise should I be concerned he flies around plays a lot eats fine weighs consistently the same dry nosteriols… read more
Kelly Jones
Kelly Jones
Doctorate of Veterinary Medicine
248 satisfied customers
My cow is 1 year and 3 weeks old. Just yesterday I saw poop
Hi, my cow is 1 year and 3 weeks old. Just yesterday I saw poop on here tail and she does not want to eat. She also seems very sluggish. … read more
Kelly Jones
Kelly Jones
Doctorate of Veterinary Medicine
248 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x