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Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 8933
Experience:  I have been a practicing veterinarian for over 30 years.
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I have a 2 year old female rescue GSD, unspayed, currently

Customer Question

I have a 2 year old female rescue GSD, unspayed, currently midway through a heat cycle. She is 6 weeks in post recovery from OCD knee surgery.
10 days ago she developed a mild cough and reverse sneezing, which went away after 2 or 3 days on its own and she was back to normal. 2 days ago, I noticed her suddenly drooling in the morning and lethargic.. but her appetite was Ok and she was drinking. I waited 24 hr and I took her to the vet yesterday.She is extremely fearful so vet examined her in the car. He said lungs sounded OK and she 'looked ok' But obv it couldnt be a thorough examination, so a possible upper respiratory infection. I came home with antibiotics and she has had 2 doses so far. I noticed, this morning that her muzzle area slightly swollen and there is a visible bump on her right side just to the side of her nose. I also noticed her poop was mucousy with yellow stringy stuff in it and she was slightly straining. Basically, She is not well, her appetite is poor, she is eating some treats and drinking water.
To summarize and give you as much info here and help you determine or eliminate possible causes-
-she is currently in estrus
-she is in post recovery after OCD knee surgery
-She came into contact with some stray dogs urine and faeces around 2 weeks ago.
-she loves chasing and snapping at bees
- she weighs 37kg or 81lbs
-we live in the UK
Medications she is on-
Tramadol 50mg x2 a day
Lyrica( pregaba) 75mg x2 a day
diazepam x 5mg x 2 a day
Synulox(antibiotic) 250mg 1.5 tabs x 2 a day
Hope I have provided sufficient info here, She is SO hard to examine and suffers with extreme anxiety, i do not want to put her under the stress of an anaesthetic or even another trip to the vets unless absolutely necessary.
Thanks in advance.
Submitted: 4 months ago.
Category: Dog
Expert:  Dr. Deb replied 4 months ago.

Hello, I'm Dr. Deb and will do my best to help you today.

I'm sorry for this concern for your dog. I do have a few additional questions to ask about her first if you don't mind:

1. Can you send me a picture of her face? The following link walks you through the process:

2. Can you take her temperature?

3. How long has her appetite been off? Is she lethargic?

4. I'm assuming she has been on Tramadol, Lyrica and Diazapam since her surgery?

5. The antibiotic is the only new drug she's taking?

There may be a slight delay after I receive your answers since I have to type up a response to you. Thanks for your patience. Deb

Customer: replied 4 months ago.
Thank you Dr Deb,
- I have attached photos of both face and poop!
-can't take temperature, she is very hard to examine. But she is warm to touch on and off throughout the day
- her appetite been off from today. She ate normally yesterday
-she is lethargic , yes but she wants to go out for a walk or garden but tires and comes back indoors quite quickly
- antibiotics is the only new drug , the other were for after the surgery
-slight discharge from eyes and eyes are red too.
Thank you again
Expert:  Dr. Deb replied 4 months ago.

Thanks for the answers to my questions and the pictures (which are very helpful, by the way)although I'm sorry I was off my computer when you did so.

I have several thoughts as to what might be going on with her and while I typically try and explain all of a patient's symptoms with one condition, it sounds as if that's not likely to be the case for her.

I understand about not being able to take her temperature although it's always helpful to know if the patient is running a fever in situations such as this. Even though she may feel warm to the touch, her core body temperature may not be elevated. If you do somehow manage to take it, normal is 100-102.5.

1. Given her propensity for chasing and snapping at bees/insects and the acuteness of the swelling on her muzzle and the bump you're seeing (which are obvious in the pictures you sent), I'd have to suspect that her facial swelling and the eyes issues are secondary to an encounter with one of these flying critters. This could also account for some of her lethargy as well.

If this were my patient, I'd advise an over the counter (at least here in the States) antihistamine such as Diphenhydramine at a dose of 1 mg per pound of body weight twice a day which would be about 75 mg for a dog this size. This drug comes in 25 and 50 mg here in the States so I'd give 1.5 pills of the 50 mg size. Sedation, unfortunately, can be seen as a side effect though so if she's already somewhat lethargic and she worsens, then you won't know if it's because of the drug she's taking or something else is going on. However, I might be tempted to give her one dose since this is often all that's required for many patients with anaphylactic reactions of this sort.

If the face and eye issues are what I think they are, then you should see improvement within just a few hours.

And, in case you were wondering, there shouldn't be any contraindications in giving Diphenhydramine concurrently with the other drugs she's taking.

2. As far as her loose stools are concerned, I suspect the antibiotics she's taking to be the culprit. It might also explain her lack of appetite since gastrointestinal signs such as diarrhea, anorexia and/or vomiting are commonly seen side effects. The yellow you're seeing simply reflects increased transit time and not anything to worry about.

I wouldn't suggest that you discontinue her Synulox but I might feed a bland diet of boiled, skinless, boneless chicken breast and 20-minute white rice for now. I'd also start a probiotic such as Forti Flora (available here in the States although I'm not sure what you might have there).

Her stools may continue to be soft the entire time she's taking the antibiotic but should return to normal once they're discontinued if the probiotic and bland diet aren't effective.

Hopefully, she'll find the bland diet more palatable than what she normally eats but if she's hardly eating anything, then I wouldn't want to continue giving her this drug on the off chance that it's the problem. If the antibiotic is discontinued and she still doesn't want to eat, then something else is going on.

3. I always worry about a uterine infection (aka pyometra) when an unspayed female becomes lethargic and/or doesn't want to eat but it's fairly uncommon for this condition to develop during an estrus cycle. More commonly, it develops 4-6 weeks after the cycle is finished. I wouldn't entirely rule it out but it wouldn't be at the top of my list either but I'll include it to be complete.

These patients can run fevers, their appetites can be off, they can be lethargic, they may be drinking more water and they often have a yellowish, pussy vaginal discharge.

This condition would be considered fairly serious since if left undiagnosed and untreated, the kidneys can be permanently damaged.

At this point, I'd rule out the most obvious, possible causes for her symptoms as I mentioned above. However, if she continues to not eat and/or remains lethargic or tires easily and/or she worsens in any way, then you may not have much of an option but for her to be rechecked unfortunately, although it gives me no pleasure to say so.

I hope this helps although, again, my profuse apologizes for the delayed reply. Deb

Customer: replied 4 months ago.
Thanks Dr Deb,
I too think there maybe more than one thing going on. All the harder to diagnose!
Cetirizine Hydrochloride is what I have in my medicine cabinet, called Piriteze in the UK. I have given this to her before when she had a hotspot.. Although not combined with the drugs she's taking now. Would you know if there are any contraindications in this case?
She is already on a bland diet, in fact plain steamed chicken breast is all she eats when she's sick. She has eaten tonight's meal of this and some treats.
I already started her on probiotics last night when I gave her the first dose of antibiotic.
Strange the swelling has just come up this morning when she could have been stung the day before. I hope she's not reacting to the antibiotic?
She is intolerant to NSAIDs ( makes her vomit) so it would not surprise me if she was sensitive! This poor dog has so many things going on. She's due for the other knee surgery in 3 weeks( yes, both knees have large lesion OCD and she has hip dysplasia too) We rescued her at 6 months old and had no idea she was broken on the inside. Very sad.
It's Sunday tmrw so I hope she starts to improve as I would hate to take her to emergency vet.
Thank you for your helpful insights. Let's hope it's a bee sting as it's the most likely thing.
Expert:  Dr. Deb replied 4 months ago.

You're more than welcome.

Poor girl; she sounds like she has had her fair share of troubles, hasn't she???

Glad you thought to start the bland diet and the probiotic:)

I suppose the swelling could be a drug reaction to the antibiotic but it's not a commonly seen one. But, I'm not a huge fan of coincidence either so I wouldn't discount the possibility. A spider bite could also cause the swelling; it wouldn't necessarily have to be a flying insect.

Give me a minute to double check if there are any contraindications to Cetirizine with the other drugs she's on. I don't think there should be a problem but I want to check the drug formulary to be sure.


Expert:  Dr. Deb replied 4 months ago.

From what I can tell from my research of a veterinary database, antihistamines should be fine to give with the other drugs she's currently taking.

If she's been given Cetirizine in the past and handled it well with no side effects, then this is the drug I'd give her. Hopefully, the swelling will diminish within a few hours.


Dr. Deb, Dog Veterinarian
Category: Dog
Satisfied Customers: 8933
Experience: I have been a practicing veterinarian for over 30 years.
Dr. Deb and 3 other Dog Specialists are ready to help you
Customer: replied 4 months ago.
Dr Deb, you are so kind to have gone through all this trouble. Really helpful thank you! I have given her an antihistamine tablet and let's hope she more comfortable.
We live on acreage ang there are many strange insects around.. It's been very humid too, plus ive seen possible blue green algae in places , but my dogs don't generally venture in those areas. ( my other dog is fine) Just hope she's ok, she has a long journey ahead. Hopefully a healthy and happy one.
Thank you so much again.
Best wishes.
Expert:  Dr. Deb replied 4 months ago.

I'm glad I could help and thanks for the rating and bonus; they're greatly appreciated.

I do so hope that you'll continue to keep me posted about her; I'd very much like to know how she does. Even though you've rated, we can continue to discuss this issue at no additional charge to you.

I'll be sending positive thoughts her way that the swelling resolves and that her other symptoms resolve in a timely manner.

Kind regards, Deb

Customer: replied 4 months ago.
Dr Deb,
I took her to the emergency vet this morning. The swelling hadn't gone down despite the antihistamine.
She was so lethargic that she allowed the vet to examine her except take her temperature. As you said, the vet also suspects insect bite/ sting type reaction. She's had an antihistamine shot. Vet said to take her home and monitor.
She's eaten chicken again. Is very sleepy due to the shot and has been laying down most of the day,every now and again she squeals as if she's in pain which is a new development..But, letting this ride out and see what tmrw brings!
Thank you again! They're such a worry when they are like this.
Expert:  Dr. Deb replied 4 months ago.

Thanks for the update.

I would have loved to have known what her temperature was (a feeling shared by your vet, I suspect) but I understand about not being able to take it.

Not sure what the pain is all about, though. This doesn't seem to fit with the other issues that she has.

I agree that worrying about our pets can prematurely turn our hair grey sometimes but let's hope that the antihistamine injection brings improvement. Deb

Customer: replied 4 months ago.
It is a shame about the temperature. It would answer some questions for sure. I just hope the swelling is not a reaction to the Amoxycillin(synulox) as despite the antihistamine the swelling has not gone down. She had one dose of the antibiotic with her chicken this afternoon today but is refusing to eat or ingest anything else right now. Thank you so much for your assistance.
Expert:  Dr. Deb replied 4 months ago.

Although I've never seen a hypersensitivity reaction to Amoxicillin myself, I did research on the aforementioned veterinary database. The following is what I found listed under Adverse Effects in the Plumb's Veterinary Drug Handbook:

Hypersensitivity reactions unrelated to dose can occur with these agents and can manifest as rashes (including serious cutaneous reactions), fever, eosinophilia, neutropenia, agranulocytosis, thrombocytopenia, leukopenia, anemia, lymphadenopathy, or full-blown anaphylaxis.

So, looks like we can't entirely rule it out. But if this is a drug reaction, then the symptoms should resolve as soon as the antibiotic is discontinued.

I have seen a few insect bites/stings take a day or more to improve even though the patient is receiving twice daily antihistamines so this is still on the rule-out list, too.

If this were my case, I'd be tempted to stop the antibiotic since so many of her current issues appear to have developed when it was started. Of course, it would be good to know if her temperature is elevated which might indicate a bacterial infection of some sort that would respond to antibiotics....just perhaps a different one.



Customer: replied 4 months ago.
I am sensitive to Amoxycillin, I come out in a rash all over, which is what made me consider the possibility..Well she hasn't accepted anything after her chicken this afternoon, so antibiotics haven't gone in at all .. Even water is a struggle now.. I am bringing her a bowl every half hour and she just takes a few little sips and lays her head back down again. The entire lower snout, above the nose is 'shiny' like it's been stretched. Very strange!
Expert:  Dr. Deb replied 4 months ago.

How strange, indeed! I don't think I've ever seen anything exactly like this on any of my patients. I'm at a complete loss to explain what's going on with her unless this is a drug reaction.

Maybe it's a good thing that she didn't get her antibiotic this evening if she's having an adverse reaction to it; the only way we'll know for sure, obviously, is for her not to receive it at all.

If she's not voluntarily drinking, then you may need to dribble water or pedialyte or low sodium chicken broth into the side of her mouth with a syringe or turkey baster. She may not like it very much but at least she'd be getting fluids.


Customer: replied 4 months ago.
Hi Dr Deb,
I took her to the vet today. The swelling seemed to have spread to her right eye, it got bloodshot and started to weep. She seemed to be in even more discomfort.The vet did a full blood profile which came back normal, also an allergy profile but the results take a while to come back. She has also had a steroid shot and antibiotic shot and eye drops. She was so lethargic and compliant that they managed to take temperature which was 39.1 degrees.
Back home she is feeling a little better and is eating and drinking and moving around more, seems the steroid really helped. The eye is still mildly swollen and I am to monitor her, the steroid should last around 3 days in her system.If no improvement she will have to go for a scan under sedation.
Thank you for all your help, it really got me through the tough part of it. This is just such a fantastic service, thank you again!
Expert:  Dr. Deb replied 4 months ago.

I'm glad you've been happy with the site and service but I'm still puzzling over what might be going on with your girl.

I'm sure they told you that her temperature was at the higher end of the range but still normal.

I've seen some odd presentations of tick diseases although I'm not sure if they're prevalent in the UK or not.

I'm glad that the steroids seems to have been effective but I'm still at a loss to explain what might have caused her symptoms in the first place since it seems that an antibiotic reaction was ruled out...or I assume that it was.

I think I may have mentioned that I've seen a few allergic cases where the patient needed steroids before improvement was seen (antihistamines just weren't strong enough) but what in the world is she allergic to???

This is a head scratcher, for sure!

Please continue to keep me updated since I'm still interested in what happens over the next few days and what her allergy testing shows...although, hopefully, she'll be completely back to normal by the time the results come back.


Customer: replied 4 months ago.
a head scratcher for us all! No idea what has caused the allergic response. Vet asked all the obvious questions, if I had changed her food/ food bowl/ used pesticides( and no we dont) We do live on acreage however,so there are many wild animals and strange insects about.. but she was out for only 5 minutes the morning it started. I suppose something in the house could have affected her just as easily. We have all been racking our brains to what went on that morning. The only thing that could be potentially a cause, is that my sister was staying with us for the week and she just returned from Mexico, she had been trekking in the jungle, maybe a bug travelled in her suitcase? She mentioned that she had been bitten over there and was still very itchy when she was with us.
I will keep you informed after I have the allergy profile results. Thank you again for your kind wishes.
Expert:  Dr. Deb replied 4 months ago.

This is one of those cases that I lie awake at night pondering.....your vet, too, I suspect:)


Customer: replied 4 months ago.
indeed Dr Deb, you and me both.. and a sign of a dedicated professional in your case :) Her white blood count came up high today, which indicates infection. Vet now thinks, possible sinus. Who knows, I will keep you informed. For now shes almost back to normal.
Expert:  Dr. Deb replied 4 months ago.

This is likely to turn out to be one of those cases where we may never, ever know what was going on but as long as she's back to normal, it may not matter all that much.....although I'd still puzzle and ponder over it.


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