Before I post here the answer of Dr. Marie, you might ask who she is? She's a well-known veterinarian in Ottawa, and she answers questions online through her site http://www.askavetquestion.com/.
Thank you very much, Dr. Marie for choosing my dog's case to feature on your site, and I am also posting your answer here to help other dog lovers who may be reading my blog.
Dr. Marie explained why my Sugar died.
Oh, I am so sorry to hear about your ordeal with Sugar and that he did not survive.
I did take some time to read your blog. It sounds like Sugar had excellent vet care.
You mentioned on your blog that Sugar was diagnosed with Ehrlichiosis. This is likely that cause of all of his symptoms.
Ehrlichiosis is spread by ticks. Sometimes a tick can be present on a dog and not be found.
One of the most significant things about ehrlichiosis is that it causes really low platelet numbers. When platelets are low it will cause the body to bleed very easily. In your blog you mentioned several signs of bleeding:
Blood in stool
bruising on the foot and leg
the black stool (indicates bleeding in the stomach)
pale gums
the tiny bruise marks on the abdomen
I can think of two possible reasons for the serious problem with the foot. The most likely is that Sugar had an infection in that foot possibly as a result of a small wound. But, because he was really low on platelets he could not heal the wound properly. Where a normal dog would have a small bruise, he just kept on bruising and swelling.
The second possibility is if he had something called "vasculitis". Some dogs in the end stages of ehrlichiosis can get a serious problem where the immune system causes tiny molecules to form that can block blood vessels. This causes extreme swelling and purple discoloration.
I am so sorry for all that you went through. From what I read on your blog it sounds like all of the right things were done in his treatment, but sometimes we just don't win against serious disease.
You are definitely welcome to post my reply to your blog. Please rest assured that you did all you could. It sounds like Sugar was a really important part of your family and will be sorely missed.
Everytime I played with my dogs I couldn't help myself but miss Sarsi so I decided to detach myself with my dogs for a week for easy and faster emotional recovery. Exactly a week has passed, my mother said Sugar was limping due to small bruise on his right front foot. We thought he was bitten by my other male dogs since he was always bullied. It was the same day we discovered that the bloody stool we saw that morning and the morning of the previous day was his, so we gave him Metronidazole with vet advise, of course.
The next day his foot was swollen, and we realized that he was licking the bruise as it looked like itchy. He didn't want to eat that morning so we decided to ask the vet to visit. Sugar was given an injectable antibiotic and vitamins. It didn't seem to be a threatening problem, I left the house the whole day but when I went home that night I was shocked to see Sugar "blinded" himself by scratching his right eye! His eyes bulged the next day. The antibiotic and vitamins given to him were continued for three days and we saw some improvements -- the swelling on his foot and eye subsided though not fully, and he ate normally. He was even arrogant with the other dogs --knowing him, I know it was a sign that he felt better.
Swollen foot, picture taken before he was brought to the hospital.
In the afternoon of the third day, I gave him canned dog food and I was happy that his appetite was really good, except that he hasn't pooped for almost three days and his eye didn't look good. The vet told me to give him Dulcolax tablet to relieve constipation, but when I opened his mouth I was shocked that his gums were pale! (in the morning it was pink!)! What could be the reason that suddenly his gums turned pale! Though he was still able to walk at that time, I was so worried so I decided to bring him to the hospital even it was already 8pm and I had to travel him for more than two hours.
Around 11pm he was given a few injectable medicines/support, some were given intramuscular while some were through the intravenous fluids (dextrose) hooked on his arms. His eye was checked and the vet said it was okay, it was already on healing stage (and he was not blind) but was just clouded with a blood clot. A few minutes after that he started to pant, but I was assured that it was just a sign of stress due to the long travel and the injections administered. Sugar's fecalyis (stool analysis) showed he has mature eggs of hookworms and roundworms! And those worms caused the bloody stool --I do not call it diarrhea because he pooped just once a day for two days and it was black but not watery. Sugar, together with my other dogs, has regular worming schedules, in fact the last time they were given an all-wormer was just two months ago!
In less than an hour Sugar stopped panting and his gums turned a little pinkish, but I noticed his breathing was not normal. The vet said it could be that Sugar's stomach was cramping since he was given Dulcolax. After another hour he pooped (it was black but we didn't see any worms), I felt relieved though --pooping was what I was waiting for, and which I thought would make everything normal to my beloved dog! However I noticed his abnormal breathing did not change but the vet said it was caused by the the worms inside his body --and Sugar will be de-wormed the following day when he has taken enough intravenous fluids to ensure his health. I also noticed two small purple spots on his body and the vet said it could be tick bites.
Sugar, trying to survive.
Some minutes past five in the morning the next day Sugar was in trouble! I noticed his swollen foot turned purple and his whole leg was already swollen and turning purple as well! Sugar was obviously breathing laboriously, he was immediately hooked on oxygen! Some medicines were administered on him, and he was on continuous monitoring; his respiratory and heart rates, his temperature and the oxygen support. That whole day seemed like days of suffering ---Sugar was gasping for breath --of course I couldn't do anything for him as I am not a vet, but for me my presence would help my dog endure the pain and continue to hold on. At first I thought the oxygen was too much thus causing him to breathe deeper, so the oxygen was lessened. Later on, the oxygen was adjusted because he was still gasping for breath. I asked why that was happening, the vet said it could be the worms were already blocking the circulation of his blood! And that was the same reason why Sugar's leg turned purple and worse, it was spreading on his body! Sadly, he couldn't be given a dewormer until he is back to health. The results of his blood exam showed his platelets 22, his hemoglobin 30 -- both way lower than normal! What could have caused his anemia? Another blood exam confirmed he has Ehrlichiosis! How could this happen, my mom has been checking my dogs daily for fleas and ticks and all my dogs are using anti-parasite shampoo!
Sugar suffered more, and to assist his breathing he was injected a medicine that will keep his heart pumping every time he could barely breathe. Yes, for a few hours Sugar lived through the machine/medicine support. Still, I did not give up. I asked the vets in the hospital (yes, all of them who were checking him) what could be the best thing to give him. I was told that they have been giving Sugar all the support that hopefully would reverse his blood cells problem but he was not responding to medicines. Last resort was blood transfusion, but one of the vets told me that there is no assurance it will turn out 100% successful! Despite that caution, I still agreed for a blood transfusion --better to take chances than to give up. The vet was able to contact a bloodbank and a possible blood donor, though blood a sample of the donor will still be taken for testing to ensure compatibility with Sugar's.
Sugar was scheduled for blood transfusion the next day provided that his vitals will turn back to normal. While Sugar was trying his best to survive, I told him he will be alright by 5pm, he can breathe effortless again by 5pm. I don't know where I got the idea of the time, but I know I was hoping for a miracle. Fifteen minutes after five, Sugar gasped his last breath.
It is so unfair why my pets who are complete with vaccinations, are dewormed regularly, given vitamins daily, and are kept clean are getting all these problems! While stray dogs live longer life. I don't know why life sometimes is unfair.
Everything will be alright. I know its no consolation and its such a big loss of love to lose a loving pet like Sarsi. I really feel your pain. But know that you have 12 dogs that need your love and affection more right now, you are their BIG MAMA and I hope this thought makes the loss a little bit bearable. In doggy heaven, there is no pain, no sickness - only love and good memories until you meet again. Take it sloow muna, you have your Mama's support din... its a very emotional and trying week for you.
Right now, sinisipon ako as I type this, but online ako if you need to talk to someone :)
