Penny the one year old Collie Cross

Penny is a typical young adult dog: full of energy and enthusiasm for life. She lives with Cathy in a small community in rural County Wicklow. When Cathy goes down to the local shop, Penny goes with her: she doesn’t need to be kept on a leash as she stays close to Cathy all the time.
The first hint that there was something wrong was on Sunday afternoon, when Cathy gave Penny dinner. She usually has an excellent appetite, wolfing hungrily into her food, but on this occasion, Penny took just one bite, then she backed away from her bowl, looking unhappy. Cathy then noticed that Penny’s usual upright posture and waggly tail had changed.
She had her head and tail down, with sad looking eyes, standing motionless. She just lay down quietly on her bed for the rest of the day and evening.
Cathy thought that Penny might have some sort of indigestion, and hoped that by the next morning, she’d be back to normal.
The following day was the Bank Holiday Monday, and Penny was no better at all. If anything, she was even more dull. She refused to get out of her bed, and when Cathy took some tasty food to her, she turned her head away from it. When she tried to stand up, she flopped over onto her side, looking unhappy. Cathy realised that there was something seriously amiss with her, so she phoned our emergency phone number.

a trip to the clinic was needed

I was on call that day, so I took the phone call. I arranged to meet Cathy at our clinic: she had to carry Penny in from his car, as she was too weak to walk.
It was immediately obvious to me that she was in serious trouble: her gums were white, rather than the normal healthy pink colour. Her heart was racing and she was breathing over twice as fast as normal.The cause of her problem was severe anaemia i.e. shortage of red blood cells.
I carried out a simple blood test to measure the severity of her anaemia: this showed that Penny had lost around half of her blood volume. She had not been visibly bleeding at all, which meant that she must be bleeding internally from somewhere that was not obvious. 
Penny’s problem was so severe that her life was under immediate threat: if radical action wasn’t taken, she’d die in the next few hours. She needed a blood transfusion, we had to find out where she was bleeding, and we had to find a way of stopping it.
This type of case is challenging for an on-call vet working on your own, so I made the decision to transfer her to the Pet Emergency Hospital which is based at Belfield in Dublin. I phoned them in advance, and so by the time Cathy and Penny arrived, the team of intensive-care vets and nurses were ready for her. She was given an immediate blood transfusion, and they did some extra tests to find out more about what was going on.

an ultrasound examination was carried out

An ultrasound examination of her chest showed that this was where she was bleeding: blood had gathered around her lungs. A blood test showed why she was bleeding so much: her blood was not clotting properly. 
The blood transfusion was a short term fix, replacing the blood she’d lost, and providing her system with clotting factors that would stop the bleeding. However the big question remained: what had caused her blood to stop clotting?

what was causing the problem

There were three main possibilities.
+ Rat poison is the most likely cause, but Cathy couldn’t imagine how Penny could have eaten any. She certainly hadn’t laid any in their own garden. Despite this mystery, it was important to cover this possibility, so Penny was given injections of Vitamin K, which is the antidote to most rat poisons. This simple treatment would not do any harm even if she had not eaten rat bait.
+ Lungworm was another possibility: dogs pick up this common parasite by eating slugs and snails (or just by eating grass, which Penny did sometimes, like many dogs). Lungworm causes coughing, but it also stops the blood from clotting, potentially causing crises like this. Penny was given a special spot-on treatment for lungworm, to cover this possibility.
+ The third possible cause was a type of haemophilia, an inherited deficiency of coagulation factors. This is rare, and it’s difficult to diagnose and treat.
I discussed the challenge of making an accurate diagnosis with Cathy and that’s when she came up with a critical piece of information. On Sunday morning, she had noticed some odd blue specks in Penny’s poo. She hadn’t though much of this: sometimes Penny was a scavenger, sometimes eating things that she found on the ground when out and about, and this occasionally made her faeces look odd.
For me, however, this news was highly significant. Many types of rat bait come in the form of bright blue granules or pellets. If a dog has eaten rat bait, the faeces often contains traces of this blue colour.
Cathy then double-checked her local area, and she confirmed that rat bait had been placed on the ground nearby. Penny must have quietly slipped away, gobbled up the poison, then ran back to Cathy.
This story has a happy ending: Penny is now doing well, fully cured by having extra Vitamin K in her diet for the next few weeks. 

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