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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 31162
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My pet English Springer Spaniel

Customer Question

Hi
My pet English Springer Spaniel, collapsed in the kitchen. He has pale mucus membrane. Not moving limbs has a still posture. He has been taken to emergency vets he has been told hypovaelemic likely? As reacted to crystalloid iv drip. However, he is still poorly, the vet asked is his stomach normally as rounded/tense I did notice was firm in house but not 100% so do not want to mislead so said do not want to say as not sure. He has noted abdo/tense? On notes.
There has been no definite diagnoses, but notes now saying NAd conscious xrays lat and dv abdo/chest and an tried abdominocentesis. Has he investigated abdo tense? Remark and what is this likely to be? His red blood cells are 3.7 andPcv 37.With Poss SMLNs sI enlarged? Pvc 28 now and discharged, with no diagnose bit dog walking still poorly.
Submitted: 3 years ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking to Dr. Michael Salkin
I'm sorry that your question wasn't answeed in a timely manner. I'll address your concerns as you posted them...

Collapse and pale mucous membranes will indicate either profound anemia or shock. Hypovolemic describes a dehydrated state or a state in which a large amount of blood has left the circulatory system.
A tense and firm abdomen suggests that inflammation exists within the abdominal cavity and Louis might be actively bleeding from, say, a ruptured splenic or hepatic tumor.
NAD means "no abnormalities detected" in the X-rays, however, and so it doesn't sound as if an intrabdominal disorder exists. I'm assuming the abdominocentesis was negative; please clarify this for me.
A red blood cell count of 3.7 is not consistent with a PCV of 37. One of those values is incorrect. A PCV of 28 indicates that Louis has been rehydrated and that dilutes the PCV (packed red cell count) giving a more true account of his anemia.
SMLN means "submandibular lymph nodes" which, if enlarged, is worrisome for systemic infection, severe allergy, or neoplasia such as lymphoma.

I need to review all of Louis's test results to be able to make more sense out of such a presentation. Can you upload a copy of his test results to our conversation? I understand that you might not have a copy of the results at home but his vet should be able to give you one which you could scan into your computer and give me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (not if you're using the chrome browser) or by using an external app such as imgur.com or dropbox.com

Please respond with additional information and further questions or concerns if you wish.
Dr. Michael Salkin and 3 other Dog Specialists are ready to help you
Expert:  Dr. Michael Salkin replied 3 years ago.
Thank you for your kind accept. I appreciate it. I'm going to check back with in a few days for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.
Customer: replied 3 years ago.

Hi Dr Salkin,

I have noticed my replies are on public page. I rather not disclosure further details unless confidentiality is attained. Main due to the data I wish to share only with a professional, is there anyway of authenticating my contact source as it has been on my mind that I am unsure if the recipient is the identified person and is genuinely that person.

Thank you XXXX.

Expert:  Dr. Michael Salkin replied 3 years ago.
Please contact***@******.*** with whom you can discuss your concerns. I'll speak to you soon. Please disregard the info request.
Customer: replied 3 years ago.

Thanks, XXXX.

Expert:  Dr. Michael Salkin replied 3 years ago.
You're welcome, Andy.
Customer: replied 3 years ago.

Hi Michael,

I have been trying to ensure that my questions are kept in undisclosed to ensure confidentiality for Louis and I.

I just need to consult his notes to get you to view them. My questions once you view them now are regarding the thoroughness of his course of treatment.The vet performed an abdomincentesis, and did note abdo tense? In notes. I assume the ? was as he asked me if his stomach was more rounded and tense. I was aware was, but said did not want to mislead him at the time so said neither yes or no. Does this mean I faulted my dog, unintentionally, in getting the correct path of diagnostic treatment? Or does it mean he still investigated the question he posed to me, which I failed to give an answer yes or no. He did also perform xrays conscious ones, but no ultrasound which I feel was wrong as he states Louis was walking around after thirty mins of the drip. He discharged him afterwardsafter four and a half hours with caution and advice to send him to night vetif Louis worsened or he became of any concern.

Expert:  Dr. Michael Salkin replied 3 years ago.
I would assume that the "abdo tense?" note meant that the vet thought that it was a possibility but wasn't sure when he/she peformed the abdominocentesis.

Has***@******.*** discussed confidentiality with you?
Customer: replied 3 years ago.

Was this test, abdomincentesis test due to the "abdo tense?" remark? Would this conclude the question, hence the test performed to satisfy the suspicion? The yes came back negative, Louis, did not get an ultrasound but the mentioned xrays. Why not? As emergency vets were later sought and they performed an abdominocentesis test which was positive. I feel earlier vet did not scientifically probe enough to conclude, he asked if was firmer, tense but I said not wanting to say as wanted him to decide and invesigate as he would know best. However, emergency vet hours later asked no questions and diagnosed Louis and positively concluded from abdominocentesis test. Earlier vet did not, Louis was carried into the earlier vet close to death, but walked into night vet not carried in and looked better but not recovered. Louis was collapsed at home and I believe first vet should have gained positive abdominocentesis test, is it possible he was incompetent on his attempt? As lab results for his blood tests stated sample was poorly collection and needed another attempt, again is this normal for vets to do this. Is he unable? I need to send the notes, to you by post I need help on this, you probably have an idea on what I am saying. I want to keep this by post now if possible, please I can pay for all your expert time and advice, let me know for costs on answers. I cannot inform anymore online I can post 10 pages of findings. If you can answer the questions I send on the notes that would be excellent. I can send payments to PayPal accounts or post cheques. If you feel you can answer fully and help me gain my answers s Tha would be great the vet is not cooperating, he only cooperates now and then and does not answer the questions most of the time. Only answering the questions he wants and not them all.

Hope you can see I am only trying to establish he got the best course of the treatment and want to piece all bit by bit. You will see everything you need on the posted notes and this kept between us.

Thanks Andy.

Expert:  Dr. Michael Salkin replied 3 years ago.
Yes, I expect so.

I don't know. Perhaps the availability of an ultrasound was poor.

When fluid is compartmentalized in a cavity, a negative tap can occur if that compartment is missed. That's less like to happen if I tap a cavity with ultrasound guidance.

Because we're not allowed to correspond outside this venue, you would need to send additional pages to***@******.*** but you would still need to confirm with support that what you sent remained confidential. That's out of my control.

It sounds as if you should consider contacting peer review for the local veterinary association to which the vet belongs. They mediate between owners and vets. Full disclosure: I was head of peer review for my local association.

I can't discuss your financial obligation to the site. I can only tell you that if you're not a subscriber, you can provide a rating as many times as you want. I receive a portion of your deposit when you rate positively. Bonuses are forwarded to me as well.