Case 27 — Hemoptysis

Primary clinician: Kris MacDonald, DVM, DACVIM (Cardiology)
Supervising clinician: Mark D. Kittleson, DVM, PhD, DACVIM (Cardiology)

Signalment

  • Species: Canine
  • Breed: Afghan Hound
  • Age: 7 years
  • Sex: Male
  • Weight: 41 kg
  • Name: Marso

Presenting Complaint

  • Bleeding from mouth

Pertinent History

  • Clients found Marso at noon standing by their pool bleeding from his mouth (about 1/2 cup). There was also some blood around the back yard. They took him to their veterinarian. He had stopped bleeding by the time they reached the clinic, where he was given a physical exam and referred to the VMTH.
  • The clients acquired Marso about 3 years ago as a rescue dog.
  • He was already debarked when they got him. He has always had a soft cough after drinking water.
  • The clients say that there is no rat bait, snail bait or other toxins on their property.
  • Marso showed no sign of illness this morning or in the past few days. He has had no illnesses while he has been with the clients.
  • He takes a heartworm preventative (lives in Sacramento, CA), but they have missed a pill on occasion.
  • They have one other dog at home who is healthy.
  • Marso is current on his vaccinations.
  • He is eating, drinking, defecating, and urinating normally.
  • There was no coughing or sneezing prior to today.
  • He eats a lamb & rice diet from the grocery store.

Physical Examination

  • General: QAR, no increased skin turgor, BCS = 4/9. T = 104.0°F; P = 130; R = panting.
  • Integument: Full shiny coat, no evidence of fleas.
  • EENT: Ears clean and not erythematous. Conjunctiva mildly injected. Cornea and anterior chambers clear. Unremarkable fundic exam. PLRs direct and consensual intact. Mucous membranes injected, CRT < 1 sec, no oral ulcers, moderate generalized tartar. Nose wet, black, no discharge.
  • Musculoskeletal: No gait abnormalities seen.
  • Cardiovascular: No murmurs heard over any region; no arrhythmias; good femoral pulses.
  • Respiratory: Normal.
  • GI: Mildly fluid-filled gut loops; no organomegaly; no masses; no pain on palpation; clean anus. Rectal exam unremarkable, except for melena.
  • GU: No bladder palpated; prepuce clean.
  • CNS: Not examined.
  • Lymph nodes: Prominent left prescapular node (2.0 cm); all others WNL.

Problems

  • Historical bleeding from the mouth / Melena
  • Hyperthermia

Laboratory Data

  • CBC: Hematocrit = 51%; WBC = 13,300/μL (Neutrophils = 11,200; Lymphocytes = 1,584/μL; Monocytes = 264/μL; Eosinophils = 132/μL); Platelets = 237,000/μL.
  • Chemistry Panel: All values within normal limits.
  • Coagulation Panel: All values within normal limits.
  • Arterial blood gas: PCO2 = 29.8 mmHg; PO2 = 91.5 mmHg.

Quiz

1. The partial pressure of carbon dioxide is low on the blood gas. What would be the best term to describe this dog’s respiration based on this finding?

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