Toa Payoh Vets Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures

THE CASE OF THE RAT-CATCHING WESTIE
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Case written: 23 May, 2009
Case updated: 23 May, 2009

"I have no objection to letting you have the blood samples to give to Vet 1" I said to the two women in their 20s on this fine sunny morning at 9.30 am. My associate who consulted in the evenings and Saturdays had treated the Westie yesterday and told the owners that he suspected liver and kidney diseases. He had told them that the blood samples would be sent to an outside laboratory today. My associate had said that the results would be available after 2 days.

However Vet 1 could produce instant haematological results and the 2 women now wanted the blood to be given to Vet 1 whose instant blood test results would tell them whether the Westie was suffering from liver and kidney diseases.

I checked the case card. The complaint was that the Westie had stopped eating. I had given this 10-year-old Westie dental scaling 2 months ago and he was all right during general examination. I had not requested blood test prior to dental work as that meant extra expenses to the dog owners. Most don't like to pay more and many Singaporean dog owners don't even send their dogs for dental check up and would live with their bad breath for years.

"I am open to owners wishing to have 2nd opinions. But have you considered that Vet 1 may not be elated to receive your blood samples collected by his competitor? He may want to collect blood again as he may not trust the blood from my Surgery. He may say that the blood collected overnight will not be good for the test and therefore he has to collect fresh blood for analysis.

Human behaviour is unpredictable. If he is not happy, do you expect your dog to be well looked after? I had bad encounters with 2 vets in this practice before. When two of my owners wanted the dogs to be treated by them, I made prior phone calls. The two vets were very busy and judging from their phone conversation and mannerism, they would rather not get 2nd hand cases.

The 2 ladies had not thought of such behaviour but they do exist. "In any case, your Westie had been barking for at least half an hour and he sure did not look as if he was going to die soon." My associate had given the necessary IV drips and treatment yesterday evening and I would rather not interfere with his case to avoid confusion.

The apparently elder of the two ladies asked, "If Vet 1 collects blood again, will the blood test be different and affected by the treatment given?"

"Yes," I said. "Your Westie in the animal holding area was barking non-stop for at least 30 minutes this morning. He did not look as if he was going to die soon and therefore needed instant blood tests. In any case, blood test results from this laboratory can be available within 24 hours if we request urgent results"

The ladies vacillated. To go to see a new vet or not to go. Doctor hopping leads higher expenses.

I asked my assistant to bring the Westie into the consultation room for me to examine and then release for the 2nd opinion. There was no point in retaining this client. Mr Saw brought in the Westie and put the dog on the consultation table. The dog stood quietly as I opened his mouth. I showed the gums to the ladies and they could see that the dog had almost white gums. "Your dog has severe anaemia and blood tests would be very useful to help the vet know what is the cause of the anaemia."

Then I palpated the anterior abdominal area. As I felt the stomach area, the Westie shivered and gave a grunt of pain. The two ladies could hear and see his reaction.

"Did you feed chicken bones to this dog?" I asked. "Does he pass black smelly stools and had difficulty passing stools sometimes?"

"Yes," the older lady nodded their head in reply to the 3 questions. "I feed him chicken bones every day."

"Some chicken bones could have lacerated his intestines over the years causing bleeding in the intestines leading to black smelly stool formation. Some fragments of bones could be passed through undigested and got stuck in his rectum temporarily causing pain in passing motion. The prolonged episodes of bleeding would have caused severe anaemia. Of course kidney disease and other internal organ diseases can cause anaemia too."

"What else do you feed this dog?" I asked.

"Well," the older lady said. "He likes to catch rats when I exercise him around the coffee shop. Sometimes he would bring me the rats behind the coffee shop."

I was surprised that this 10-year-old senior could still hop around to catch rats. But he looked compact and solid. Some incipient cataracts but he was living his life to the fullest by catching rodents.

"Have you read in the Straits Times newspapers about two people dying after eating rojak (fruits and vegetables in a prawn paste) in a Geylang Serai food court? recently" I asked the two ladies.

"Yes," the ladies could not connect the topic of food poisoning deaths in two human beings with their Westie's severe anaemia but were too polite to tell me.

"Well," I said. "Some patrons of this food court said that there were many rats in the food court running around."

Rats are common in food courts and they can be large and plump. They hide inside the sewers near the food court and though rarely seen during the day-time, they can be seen at night.

So what has rats in Geylang Serai to do with this Westie's severe anaemia?  He had never been to Geylang Serai and had no diarrhoea unlike the food poisoned patrons of the rojak stall.

I postulated, "The government authorities came to investigate. Therefore the food court management and the town councils instituted an aggressive cleaning up program. I am sure that the pest exterminators would be called in to get rid of the rats. Other food court operators in Singapore would take similar actions. They would use rat bait poisons to kill the elusive and fast-running rats beside other methods."

"So what?" the ladies sent me their thoughts by telepathy and awaited patiently for the connection.

"It is possible that your Westie had eaten rats poisoned by rat poison put out by the food court operator who would want his licence to be renewed by the government.

The exterminator would position more rat bait poison granules in boxes on the areas where the Westie went hunting for rats. The bait is very attractive to dogs too. So, it is possible that your Westie had ingested them. The poison went to his blood system and destroyed his red blood cells.

The ladies were a captive audience. But they did not say a word and so I did not know whether they understood me.  

I continued, "So, the Westie developed internal bleeding. This loss of blood showed in the paleness of his gums and tongue. The blood results should come in within 24 hours if you are still interested in me sending the samples this morning."

The ladies came to the Surgery early at 9 am. They had phoned my assistant to stop the 3 bottles of blood tubes from being given to the laboratory. 

The soft-spoken gentle ladies decided to give me a reprieve. I mean they decided to wait for another day. In the meantime, I gave this Westie 2 ml of Vitamin K1 subcutaneously. My associate had given the Westie intensive IV drip and that was nothing more to be done except for a blood transfusion. As the dog was barking and looking OK so far, there was no need for a blood transfusion.

Later in the evening, the blood results came in by fax and I informed the ladies that the Westie had very low red blood cells and platelets. It was possible that he had rodenticide poisoning. A viral infection was ruled out as his white cell count was normal. He could be suffering from chronic bleeding of the gut too due to chicken bone damage, hence the severe anaemia. The first tentative diagnosis was rat bait poisoning. 

The next morning, the ladies visited the Westie. Mr Saw brought the dog onto the consultation table. The Westie moved his head away and struggled and preferred that I did not open his mouth. But I had to pry his mouth open.

What would be the colour of his gums after I had given him the Vitamin K1 antidote?

The ladies gasped in surprise. Not really as Chinese ladies seldom express their feelings so openly unlike Caucasians. They opened their mouths in astonishment as they saw a bright reddish radiance in the Westie's gums compared to 24 hours ago.

As if the Vitamin K1 was an antidote and had helped to produce more blood. Of course there was the protein and other IV drips given to this dog. But the results were spectacular. From snow white to a reddish tinge. This was what counted. An excellent outcome. Not just talk and talk.

The Westie was warded for around 5 days. I did not give him any more Vitamin K1. He needed time to regenerate the red blood cells.  His blood tests showed he had kidney and liver malfunction as well. This could be caused by his suspected ingestion of the rat bait poison. 

The important thing for the two ladies was that the Westie had regained his gum colour at the end of 5 days (see picture) and could go home much alive. He had clean gums as he had a dental scaling some 2 months ago and so the bacterial infections in his mouth had been eliminated.

As for his rat-catching days, I guess that the ladies would retire him. In this economic depression, the Westie would be considered retrenched as his services were no longer required. But he would never be homeless. I have no doubt that he would always receive tender loving care till the end of his life.