Veterinary Circles: Veterinary Discussions and Experiences

Hi,

I have a pacient with very limited finances and complicated problems. The dog is a three years old intact female, Romanian shepherd dog (Carpatin). Her problems begun when she was 7 months old: itching and loosing her fur. The dog was treated several times (the owners do not really know with what), the response was partial and every time the symptoms returned. I saw the dog for the first time three months ago. She had diffuse alopecic areas on her front limbs, flanks, chest, under the chin, belly, backline, part of them seemed to be chronic. She was so pruritic than she could not eat her food without scratching herself. Part of the lesions produced by scratching were infected. I gave her Enrofloxacine p.o. and a product called Exemtrat, tablets containing some vitamins but Dexamethasone in the first place. She responded great, after three days there were no sings of pruritus. We agreed with the owners that they will buy her essential fatty acids, a product called Nutrivet. They did not. THe treatment lasted for 10 days, the dexamethasone was lowered in dose gradually. Three weeks after the end of the treatment the dog begun to be itchy again. The owners did approximately the same treatment protocol as we did together at the first time, they did not called me until the problems appeared again, some time after they stopped the second bout of treatment. When I saw the dog part of the hair on her limbs and on her back was grown back but she was scratching herself and she had some lesions again. Now she is on Prednisolone and Amoxicillin+Clavulanic Acid p.o., from five days, and she is responding extraordinarily well - she is not pruritic anymore (again). The fact I found out this time is that the dog is drinking a lot of water, about 7-9 L/day, she has maximum 40 kg in weight. THis means that it is clear polydipsia. I made a quick blood sugar test, it was 121 mg/dL. The owners wanted to limit all the costs, they wanted only a basic blood biochemistry panel. Here are the results:

Parameter	Measure unit	Result	Reference range
Alcaline phosphatase (PA)	U/L	49	10,6 – 101
Alanin amino-transferase (ALT)	U/L	24	8,2 – 57
Aspartat amino-transferase (AST)	U/L	30	9,2 – 40
Bilirubin - total	mg/dL	0,08	0,1 – 0,6
Bilirubin - direct	mg/dL	0,03	0,0 – 0,4
Protein - total	g/dL	10,72	5,5 – 7,5
Urea (BUN)	mg/dL	13	8,8 – 26
Creatinin	mg/dL	0,75	0,5 – 1,6
Colesterol	mg/dL	132	116 – 254
Free thyroxin (FT4)*	pmol/L	13,58	6 – 23

I do not have the answer why is she drinking that much water. Because the fact that the serum proteins were high, I could suspect some immunological problem (we did not determined the immunoglobulins). I post here some pictures of the dog. Food allergy can not be excluded because the owners say that they can not follow an elimination diet for the dog (too expensive). Flea/mite/environmental allergy is not excluded, even if the problems had no seasonal variation or dependency.
If you have any idea, please write!