Pharyngitis in Dogs

Hi my miniature poodle was prescribed Rilexine and Tolfedine 5 days ago, since my vet said he has a throat infection. I didn't see any improvement and yesterday morning he vomited sort of clear, yellowish liquid. He hasn't eaten anything for 5 days, almost 6 now!

I took him to the vet again yesterday and he asked me to stop the Rilexine and gave me Marbocyl P instead, since he said Rilexine weren't working on the infection. The vet gave him an antibiotic injection shot and a Foltedine injection shot. However about two hours later, at home, he vomited yellowish liquid again..I presume it was the medication. He is currently also on VetMedin, Fortekor and Furosemide since he has Congestive Heart Failure.

I'm mostly concerned because he's taking so much medication yet hasn't eaten anything for 5 days now. Only drinks a little water when I urge him to. All he does is lie down breathing a bit heavily and occasionally gets up to move from place to place. Most of the time when he coughs, he seems like gagging, that's why he then vomits too.

This morning then I took him again to the vet as after I gave him the Marbocyl and Tolfedine he vomited again. The vet told me his heartbeat was a bit not in control and gave him 4 injections: vitamin, furosemide, antibiotic and anti vomiting. He has since drank a bit of water and the vet prescribed Nutri-Cal.

What worries me most is that he's taking all this medication and not eating and getting really lethargic.

I'm wanted to get a second opinion. Few weeks ago my 2 yr old sheperd, Carina, cut her pad. I took her to the vet because I could not get the bleeding to stop. They bandaged her up and told me to keep an eye on it sent me home with some antibiotics. And told me to try the antibiotics to see how she was because they know that she does not take well to any type of medication or antibiotics. Obviously should not take well to the antibiotics but I did give her four doses and kept wound clean 3 times a day. Carina is a extremely active and somewhat obnoxious if not giving attention type of dog. About a week ago one morning I was talking to the neighbor through the fence normally she be barking incessantly trying to get me to throw her stick. She barked once and her bark was hoarse and immediately stopped. In that early afternoon I was sitting out of the front of my house she was not playful and just sat in the grass which caused me to check her temperature. I noticed her temperature was 100.5. Throughout the night it ended up getting up to 103.7 but I ended up getting it to go down with cool rags and the fan. I took her to the vet the very next morning the minute they opened. They said for the most part she was fine and then her wound was healing nicely and I could stop the antibiotics and didn't think much of the fever or the bark. She is not really coughed or barked and she still eats and drinks. However the first day that I gave her the antibiotics after the cut she did throw up something but I figured it was because she did not have a full meal and she doesn't take well two antibiotics. She coughs sometimes and almost rarely but there are a couple of coughs that she has but it's usually after her eating grass or maybe taking in some water after going in the lake. She is not reading a fever anymore but very lethargic and doesn't want to play as much as she used to but still does. The vet seems to think she's okay but these are just symptoms that she does not usually exhibit and I'm worried if I should go get a second opinion from another vet so I thought I'd see what you thought. I was reading up on that disease about the pharyngitis or something more serious. She has had some of the symptoms like drooling but that was several weeks ago and that doesn't always happen now. About a month ago I noticed that her neck might have been a little bit more swollen but it didn't have any other symptoms at that time and it does not seem swallowing now. She hacked sometimes but it's usually after eating grass because she's always had a digestive issue. And I don't know if these are common things or something that I should be more concerned about if a dog had some kind of complication like kennel cough or the above-listed issue with the coughing and gagging and vomiting happen all the time would you see them all together or could they should be spaced out over a couple of months maybe I'm just reading too much into stuff.p.s.she no longer has a fever but she will not greet me when I come into the house she is very lack of energy and doesn't want to play in the morning after waking up and she will not bark and I'm guessing it's because it's hard for her she eats all food but won't eat her kibble but will definitely eat chicken or eggs or any other food I made for her so she doesn't have a complete loss of appetite

From: Frank Bailey Gelder ClD Pathology, ASCP, Diosed p ABHI, PhD Pathology
Referred to me from my Daughter Rachel Gable as pet owner. I would like your unbiosed opinion. Thank you. Frank: [email protected]

INTERNAL MEDICINE
Candice Bailey, DVM, MS, DACVIM
Kristen Parker, DVM, MVSc
Ashleigh Seigneur, DVM, MVSc, DACVIM
RICHMOND I 5918 West Broad Street, Richmond VA 23230 P 804.716.4700 F 804.716.4705 Elizabeth Turner, DVM
Patient: Bella Client: Eric Gable
ID: 374803 Contact Info: 112 North Plum Street
DOB: 10/4/2014 Richmond, VA 23220
Species: Canine (804) 528-7988
Breed: Poodle Mix
Sex: Spayed Female
Color: brown/white Date: Tuesday, December 12, 2017
Dear Dr. Mason:
Pending tests:
Please see lab work below.
Assessment/Plan:
We discussed these results with Mr. Gable. There are some concerning changes to the epithelial cells present that could
represent a neoplastic process. However, with the entire case considered, there is also major concern for dysplastic change
secondary to inflammation. We still cannot rule out an immune-mediated process. At this time, the owners would like to pursue the
addition of another immunosuppressant with Dr. Williams and hold on advanced imaging of the region. The plan is to add
mycophenolate @ 125mg q12h. Veterinary Dermatology of Richmond has prepared this medication for Mr. Gable to pick up.
SOURCE/HISTORY:
6 months ago, patient developed cough and oral ulcerations. Responded to prednisone and cyclosporine. Cough has returned
with debris prednisone. Following activation, red-tinged fluid collected from endotracheal tube.
MICROSCOPIC DESCRIPTION:
Two slides, one previously stained, of high cellularity are examined. Large numbers of erythrocytes are present within a variably
dense, often thick eosinophilic proteinaceous background. The leukocyte population consists of primarily nondegenerate
neutrophils with smaller numbers of vacuolated hemosiderin laden macrophages. Occasional macrophages exhibit erythrophagia.
The moderate numbers of superficial squamous epithelial cells are present individually and in variably sized sheets. The
remaining nucleated cell population consists of small to moderate numbers of polygonal cells that are present individually and in
variably sized tightly cohesive clusters. The cells contain small to moderate amounts of deeply basophilic cytoplasm and round to
ovoid nuclei. The chromatin is finely to
coarsely granular and nucleoli, when visible, are basophilic and round to ovoid. There is mild to moderate anisocytosis and
anisokaryosis in this population. An extensive search reveals no intracellular microorganisms.
MICROSCOPIC INTERPRETATION:
Neutrophilic inflammation with epithelial atypia. See comment.
COMMENTS:
A cause for the inflammation is not identified on the slides. The absence of visible microorganisms does not preclude infection.
Given the presence of significant inflammation, it is not clear whether to polygonal cells represent a reactive or neoplastic
population. Given the chronicity of the disease process and relatively young age of the patient, reactive change is considered
more likely. Findings need to be interpreted in conjunction with any other relevant information and the clinical impression. Thank
you for including the relevant clinical history; it is greatly appreciated.
PATHOLOGIST:
Jennifer Steinberg, DVM
Diplomate, American College of Veterinary Pathologists
Direct: 410-424-3545
1-888-433-9987, option 0 x43545
Email: [email protected]
Thank you for entrusting Dogwood Internal Medicine with Bella's care. Please let us know if you have any questions or concerns
about this case.
Sincerely,
Candice Bailey, DVM, MS, DACVIM
2. INTERNAL MEDICINE
Candice Bailey, DVM, MS, DACVIM
Kristen Parker, DVM, MVSc
Ashleigh Seigneur, DVM, MVSc, DACVIM
RICHMOND I 5918 West Broad Street, Richmond VA 23230 P 804.716.4700 F 804.716.4705 Elizabeth Turner, DVM
Patient: Bella Client: Eric Gable
ID: 374803 Contact Info: 112 North Plum Street
DOB: 10/4/2014 Richmond, VA 23220
Species: Canine (804) 528-7988
Breed: Poodle Mix
Sex: Spayed Female
Color: brown/white Date: Monday, December 04, 2017
Dear Dr. Bowers:
History:
Bella, a 3 Yrs. 3 Mos. old Poodle Mix, was referred to Dogwood Veterinary Internal Medicine service for further
evaluation of throat clearing/hacking. Bella had an acute onset of hacking up in June. This started after Bella had
some form of dietary indiscretion that involved a bone. The owner pulled a bone out of Bella's mouth. She was taken
to her pDVM and no foreign body was found but was found to have severe gingivitis and a broken tooth. This tooth
was extracted and she was started on Clindamycin and later Doxycycline. Bella's hacking improved some on
antibiotics but returned around the time she also presented with oral ulcers and a severe ear infection. She was seen
by Dr. Williamson at VDR and started on Prednisone and Cyclosporine. Her ear infection has resolved and the oral
ulcers are mostly resolved. She began hacking and neck extending. When attempting to taper the prednisone Bella's
symptoms returned. Bella continues to hack on a daily basis. Owner reports that it occurs primarily after Bella wakes
up or drinks water. Owner also reports that Bella's bark is decreased first thing in the morning but normalized
afterwards. Owner says that Bella has hacked after drinking water since she was a puppy.
No V/D/S. E/D well.
Diet: Wellness Adult Dry; 1.5 cups BID + 1 cup sweet potatoes and/or green beans
Current medications:
Prednisone 20mg tab: 1/4 tab (5 mg) BID
Cyclosporine 100mg tab alternating days: 100mg q24h, then 100mg q12h
Examination findings:
Vitals:
12/4/2017
2:54 PM
Vital Sign RW
Weight 24.1 kilograms
Temp 101.8
Pulse 160
Resp panting
MM pk
CRT <2 sec
Alert BAR
Systems exam:
BCS: 6/9
Hydration status: clinically adequate
EENT: clear occular discharge OU
Oral: SEE BELOW
Cardiovascular: no murmur ausculted, normal rate & rhythm, pulses strong & synchronous
Respiratory: lungs clear, normal bronchovesicular sounds bilaterally
Lymph nodes: no obvious lymphadenopathy identified
Abdominal palpation: within normal limits
Neurologic: NSF
Musculoskeletal: muscle wasting on head and along spine, ambulatory all 4s, no obvious lameness
Integument: NSF
Rectal: WNL
Diagnostic Results:
3 -View Thoracic Radiographs: 3 thoracic radiographs are available. The cardiovascular structures • are normal for
size and shape. No definitive mediastinal or pleural abnormality is seen. There is a mild diffuse interstitial and
bronchial pattern. The trachea is normal for diameter. The extrathoracic osseous and soft tissue structures are
within normal limits. CONCLUSIONS: Chronic diffuse tracheobronchitis. Allergic, inflammatory and infectious
etiologies are possible. Airway sampling with culture and cytology may be helpful. Otherwise normal thorax.
• CBC: WNL
• Chem17/Lytes: glob 4.8
• PCV/TS: 52%/8.0 g/dL
• Sedated orolaryngeal exam: marked hyperemia of caudal pharynx, 2-3 small 2mm ulcerative lesions cd hard
palate, 1mm red blister lesion cd hard palate, bilateral laryngeal pararesis with marked hyperemic and inflamed
arytenoid cartilages, bilateral tonsilar swelling, tonsils outside of crypts, 2-3mm ulcerative lesion inner upper left lip
region, moderate dental tartar, no mass lesions identified.
Problem List:
Chronic hacking cough with neck extension movements
Bilateral laryngeal paresis
Marked laryngitis
Bilateral tonsilitis
Ulcerative oral lesions
Hx of concern for immune mediated disease
Hx of clear nasal discharge
Hx of clear to cloudy occular discharge
Hx of marked otitis externa
Pending Diagnostics:
None
Treatment:
INCREASE Prednisone from 5mg q24h to 10mg PO q12h
Clindamycin 300mg cap: 1 cap PO q12h x2wks. written prescription provided
Post procedure:
Dex SP 3mg/mL: 0.12mg/kg (3mg, 1mL) IV once in the hospital
Butorphanol: 0.1mg/kg IV once in the hospital
Plan:
Discussed with owner that Bella's case is not straight forward. Considering she responds to higher doses of
prednisone, we would consider fungal or bacterial infection as the main etiology less likely, and an immune-mediated
component higher on the list of differentials. Thus far, there has been no evidence of a neoplastic process (can't be
completely ruled out right now). Once Bella's prednisone was tapered her symptoms returned. At this point, based on
Bella's history and clinical signs, for an anatomic diagnosis, we are mostly concerned about her laryngeal/pharyngeal
region. This could be a fucntional or mechanical issue. Considering these changes started after Bella had some sort of
dietary indiscretion (owner pulled bone out of her mouth), it's not clear whether or not this could have been a trigger for
her immune system. We can't rule out migration of foreign material that may require advanced imaging to identify.
Recommend to start with 3V chest films, getting the cervical region on the right lateral in addition to CBC, chem/lytes.
We will then move to a sedated oral exam. Pending these results, we can decide if we need to use the scope.
Discussed with owner the findings of the chest films, labwork, and sedated oral exam. We have not been able to
identify a definitive etiology; however, note that Bella's larynx is not moving appropriately (bilateral paresis). We
suspect that this is secondary to the marked inflammation in the caudal pharynx and laryngeal regions, along with the
other changes.. See sedated exam notes listed above. We susepct that these changes are the causes of her neck
extension movements and hacking. We were able to obtain biopsy samples from one of the ulcers on the hard palate
and a blister lesion and recommended to submit these for histo. Owner declined submitting these biopsies because
we could not guarantee that these results would change approach to therapy considering Bella responds to higher
doses of steroids and VDR was considering adding another immunosuppressant in attempt to get Bella off of steroid
therapy. For now will increase Bella's prednisone therapy, add 2wks of clindamycin considering the amount of irritation
secondary to the procedure, and recommend to follow up with VDR for further care.
ADDENDUM: material/fluid from the ET tube was serosanginous to hemorrhagic. Preliminary in house cytology
showed cells that had possible criteria of malignancy. Discussed this with owner at discharge and recommended
submitting these slides to a pathologist for cytology. VDR will hold on adding mycophenolate until cytology results
return. Owner to communicate with family about submitting the cytology and will call back tomorrow with decision. We
were unable to identify a mass lesion on the oral exam today. Discussed with owner that if the cytology returns
concerning for a neoplastic process, advanced imaging should be considered to find the lesion.
Will increase Bella's prednisone back to 10mg PO q12h and add clindamycin pending the cytology results.
Thank you for entrusting Dogwood Internal Medicine with Bella's care. Please let us know if you have any questions
or concerns about this case.
Sincerely,
Candice Bailey, DVM, MS, DACVIM
Rebekah Merritt, LVT (Internal Medicine)
3. BELLA GABLE
PET OWNER: ERIC GABLE
SPECIES: Canine
BREED: Poodle
GENDER: Female
AGE: 3 Years
PATIENT ID: 374803
Dogwood Veterinary Emergency and
Specialty
5918 West Broad Street
Richmond, VA 23230
804-716-4700
ACCOUNT #:
ATTENDING VET: Candice Bailey, DVM,
MS, DACVIM
LAB ID:
ORDER ID: 55423
DATE OF RECEIPT: 12/4/17
DATE OF RESULT: 12/4/17
IDEXX Services: ProCyte Dx Hematology Analyzer, Catalyst One Chemistry Analyzer
Hematology
12/4/17 10:15 AM
TEST RESULT REFERENCE VALUE
RBC 7.36 5.65 - 8.87 M/μL
Hematocrit 49.8 37.3 - 61.7 %
Hemoglobin 17.5 13.1 - 20.5 g/dL
MCV 67.7 61.6 - 73.5 fL
MCH 23.8 21.2 - 25.9 pg
MCHC 35.1 32.0 - 37.9 g/dL
RDW 17.7 13.6 - 21.7 %
% Reticulocyte 0.5 %
Reticulocyte 33.1 10 - 110 K/μL
WBC 8.77 5.05 - 16.76 K/μL
% Neutrophil 58.1 %
% Lymphocyte 24.4 %
% Monocyte 12.4 %
% Eosinophil 4.9 %
% Basophil 0.2 %
Neutrophil 5.09 2.95 - 11.64 K/μL
Lymphocyte 2.14 1.05 - 5.1 K/μL
Monocyte 1.09 0.16 - 1.12 K/μL
Eosinophil 0.43 0.06 - 1.23 K/μL
Basophil 0.02 0 - 0.1 K/μL
Platelet 338 148 - 484 K/μL
PDW 12.6 9.1 - 19.4 fL
MPV 10.3 8.7 - 13.2 fL
Plateletcrit 0.35 0.14 - 0.46 %
Generated by VetConnect® PLUS December 29, 2017 03:46 PM Page 1 of 3
BELLA GABLE PET OWNER: ERIC GABLE DATE OF RESULT: 12/4/17 LAB ID:
RBC Run
Download
RBC
RBC_FRAG
PLT
RETICS
WBC
WBC Run
Download
NEU
MONO
URBC
EOS
BASO
LYM
Chemistry
12/4/17 10:23 AM
TEST RESULT REFERENCE VALUE
Glucose 113 74 - 143 mg/dL
Creatinine 0.8 0.5 - 1.8 mg/dL
BUN 14 7 - 27 mg/dL
BUN:Creatinine
Ratio
17
Phosphorus 4.2 2.5 - 6.8 mg/dL
Calcium 10.3 7.9 - 12.0 mg/dL
Sodium 150 144 - 160 mmol/L
Potassium 4.9 3.5 - 5.8 mmol/L
Na:K Ratio 30
Chloride 112 109 - 122 mmol/L
Total Protein 7.9 5.2 - 8.2 g/dL
Albumin 3.1 2.3 - 4.0 g/dL
Globulin 4.8 2.5 - 4.5 g/dL H
Alb:Glob Ratio 0.6
ALT 18 10 - 125 U/L
Generated by VetConnect® PLUS December 29, 2017 03:46 PM Page 2 of 3
BELLA GABLE PET OWNER: ERIC GABLE DATE OF RESULT: 12/4/17 LAB ID:
Chemistry (continued)
TEST RESULT REFERENCE VALUE
ALP 69 23 - 212 U/L
GGT 2 0 - 11 U/L
Bilirubin - Total 0.2 0.0 - 0.9 mg/dL
Cholesterol 227 110 - 320 mg/dL
Amylase 271 500 - 1,500 U/L L
Lipase 666 200 - 1,800 U/L
Osmolality 299 mmol/kg
Generated by VetConnect® PLUS December 29, 2017 03:46 PM Page 3 of 3

4. Pathologist's Report
SOURCE/HISTORY:
6 months ago, patient developed cough and oral ulcerations. Responded
to prednisone and cyclosporine. Cough has returned with debris
prednisone. Following activation, red-tinged fluid collected from
endotracheal tube.
MICROSCOPIC DESCRIPTION:
Two slides, one previously stained, of high cellularity are examined.
Large numbers of erythrocytes are present within a variably dense,
often thick eosinophilic proteinaceous background. The leukocyte
population consists of primarily nondegenerate neutrophils with
smaller numbers of vacuolated hemosiderin laden macrophages.
Occasional macrophages exhibit erythrophagia. The moderate numbers of
superficial squamous epithelial cells are present individually and in
variably sized sheets. The remaining nucleated cell population
consists of small to moderate numbers of polygonal cells that are
present individually and in variably sized tightly cohesive clusters.
The cells contain small to moderate amounts of deeply basophilic
cytoplasm and round to ovoid nuclei. The chromatin is finely to
coarsely granular and nucleoli, when visible, are basophilic and round
to ovoid. There is mild to moderate anisocytosis and anisokaryosis in
this population. An extensive search reveals no intracellular
microorganisms.
MICROSCOPIC INTERPRETATION:
Neutrophilic inflammation with epithelial atypia. See comment.
COMMENTS:
A cause for the inflammation is not identified on the slides. The
absence of visible microorganisms does not preclude infection. Given
the presence of significant inflammation, it is not clear whether to
polygonal cells represent a reactive or neoplastic population. Given
the chronicity of the disease process and relatively young age of the
patient, reactive change is considered more likely. Findings need to
be interpreted in conjunction with any other relevant information and
the clinical impression. Thank you for including the relevant clinical
history; it is greatly appreciated.
For veterinarians not currently viewing this pathology report in
VetConnect PLUS, please log onto www.vetconnectplus.com today to see
the image associated with this case, at no additional cost. If you
need help logging on, please contact your local IDEXX Customer Support
Team.
PATHOLOGIST:
Jennifer Steinberg, DVM
Diplomate, American College of Veterinary Pathologists
Direct: 410-424-3545
1-888-433-9987, option 0 x43545
Email: [email protected]

I have a 8 1/2 month old male bull mastiff he's suddenly today had anbert swolllen throat really big and sore for him to eat drink and swallow what could this be?

Hello, my female white German Shepherd recently has a decreased appetite. She’s also a very active dog that has suddenly gotten lazy. She just had heat 2 weeks ago so know it’s not that. The little I urge her to eat makes her give a painful expression and she usually backs off. She’s 4 years old. Please help me out. 😩 she did eat a dead deer gut a few weeks ago by accident on a hike. Im wondering if she caught a bacteria?

Hey.. my pup mario swallowed a bone by accident a week ago and cried a lot after he swallowed it.. We helped him by tapping his back and pulling up his hind legs.. we rushed him to the vet and he vomited once while on the car.. (he sometimes vomits while travelling) there was no bone or anything in his vomit. After reaching the local vet he barked once when he saw another dog and then stopped. The vet looked at him and said that thers no bone stuck in his throat and that he’ll be fine.. but from that day he lost his appetite. I tried to feed him milk he only took a sip or two and then moved away as if in pain. And he also lost his active mood.. he was a very active pup who never sits still when he is released. But now he feels week and lies under the couch all day. We were concerned and took him to the vet again. And he gave him an antibiotic injection and some medication for gas and apetite. We waited for two days but he was not getting better instead he also stopped sipping milk.. we were very concerned and took him to an advanced vet hospital where they took his X Ray and examined it to confirm that there was no foreign body in his throat.. they then told me that he has a swelling in his throat and probably has an infection. And they also told me that due to the swelling his breathing is mildly heavy. They prescribed 5 doses of antibiotic injections (one per day) along with 100ml of iv solution (DNS). We’ve been giving him this for 3 days now. He was feeling a bit relaxed for a while but then on the 3rd day (today) he developed a breathing problem.. his breathing has become very heavy and forced.. he feels week and he cannot lie down for more than 10 mins because his breathing is difficult. He just stands there and breaths for a while and walks around all the time.. he hasn’t slept at all till now ( about 20 hours ). We’re very worried and don’t know what else to do.. seeing him in pain is really difficult and makes me wanna cry.. how long will he be like this.. how long will he take to recover? Do I have to take him to the vet again and do an endoscopic examination? They hesitate to do it because he has to given Anastasia for the process.. what should I do?