ANIMAL HEALTH - GENERAL EXPERT FORUM
Clotting factors issue; uncomfirmed cause

Clotting factors issue; uncomfirmed cause

On Friday 22 Oct. my dog had a procedure to have his teeth cleaned and two small masses removed, from the left side of his face and from his left lateral hock.  The one on his face turned out to be merely a wart, and in any case both were found to be benign.  As they were both superficial, no sutures were required.  There were no clotting problems at the time of the procedure and he went home without issue the afternoon of it without event.  He started seeping small drops of blood from the facial incision (and only that incision) two days later, so we purchased an e collar, presuming he might be scratching at it with his dew claw and opening up the scab.  However, by the following morning (the 25th) there was a very large amount of bright red blood saturating the fur of his head and neck and smeared around the inside of the e collar, so we rushed him back to our vet.  They cleaned up the area, found that the insicion had not been widened in any way, and put in two sutures.  He slept (back in the e collar) during that day, and we did not observe him messing with the incision whatsoever.  Nonetheless, by 5:30, he was soaked with blood again.  We rushed back to our vet and they applied a pressure bandage, presuming again that he had somehow agitated it to cause it to bleed (the other incision was not bleeding at all).  The e collar went back on over that, but it was less than 4 hours before that was saturated and blood was leaking out of the pressure bandage.  (cont'd below)
Type of Animal
:  
Dog (Neutered)
Age of Animal
:  
13 Human Years
Sex of Animal
:  
Male
Breed of Animal
:  
Jack Russel Mix
Last date your pet was examined by a vet?
:  
October 26, 2010
City
:  
Columbus
State/Province
:  
OH
Blood Test Results
:  
BEFORE TX:  PCV 41%, Total Solids 4.6 g/dl, PT out of range (normal 12-17), PTT 235 (normal 71-102); AFTER TX (Plasma transfusion 120 ml IV over 4 hours, P-148 +20 mEq/L KCl at 45 ml/hr once transfusion completed): 34%, TS 4.8 g/dl, PT 20, PTT 112
Other pertinent test results
:  
Physical, bloodwork and urinalysis in mid-September showed:

*Hypothyroid-now on levothyroxine .1 mg bid
CBC Complete Blood Count-normal
Chem Profile Extensive-normal
Heartworm Test-negative
*Urinalysis-UTI (treated w/ Clavamox 125 mg bid 14 days, at which point we rechecked urine)
Teeth needed cleaned and small mass on left lateral hock.  Decided to schedule twilight anesthesia to do teeth and remove mass.  Removal of an additional mass found on his face at a later time was added to the procedure.  Otherwise in good health per physical exam.
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2 Comments
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612876_tn?1328033817
We raced him to OSU College of Veterinary Medicine's Small Animal Hospital.  He was taken in through the ER and while being assessed there, the incision on the leg started seeping blood as well.  They tested his clotting factors (see test results) and he was admitted to the ICU.  Under presumption that the most likely cause was rodenticide poisoning, especially in light of his relatively clean bill of health re: his physical in Sept, he was treated for that with plasma transfusion and started on Vitamin K regimen (minimum 30 days).

My question is that if we are wrong and it is not rodenticide poisoning, what other conditions are consistent with sudden onset of coagulation difficulties such as this (i.e. he was clotting fine on Friday, slowly started to have problems on Sunday, and rapidly deteriorated Monday including likely internal bleeding)?  Of these, which would be left if we rule out any that should have shown up when we ran the the chem and CBC last month?  Of what's left, is there anything that would be simple/inexpensive to rule out, easy to treat/manage/cure, or is everything complex like organ failure and cancer?  The vet at OSU said that the probability is high that it was rodenticide poisoning, but I'm just trying to wrap my mind around what the other contingencies might be so I can steel myself for whatever may lie ahead.
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612876_tn?1328033817
Just bumping my question back up to the front page in hopes that it might get a response.
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