The colour of the tongue tells a lot about the prognosis. In this case, I showed the owner that the dog's tongue was abnormally maroon and bluish. "In my experience, dogs with this colour of tongue and a dry tongue is going to die soon. Your dog also has heart disease."

"I require a blood test in this case as this was the second time the dog had poisoning signs and his kidney and liver may be damaged." The owner gave her consent.

Shih Tzu, F, 2 years.
Presenting Sign: Salivation. Non-stop vulva licking for 2 days upset the owner. The pest control people fumigated the apartment the previous day for a second time.

Tentative Diagnosis:
Insecticide poisoning. Unknown insecticide used by the pest control people.

History
4.8 kg 39.3 deg C. Jan 19, 2010
Pest control came yesterday. Salivation. Vet 1.
IV treatment, atropine recovered next day.

4.2 kg 39.8 deg C. Jan 27, 2010.
Pest control came yesterday.
Dog started salivation. Non-stop watery and profuse. Vulval itchiness seen as  continuous licking. "She passed black stools," the owner said. "The dog had bleeding in the stomach from insecticide poisoning," I replied.
The tongue colour - maroon red and bluish and dry. A sign of poor health. Is she going to die soon?
 

Insecticide unknown. IV treatment, atropine and Lasix IV. But no vomiting or coughing. Recovered and went home after 2 days. Tongue became normal pink after 2 days of treatment. The dog went home.

However, if my assistant tried to open the mouth to for me to take photograph, it turns bluish. The dog does not show signs of heart disease presently.

The apartment floor should have been thoroughly cleaned as I presumed that the pest control man must have fogged the whole place it to death.

The dog had stepped on the chemicals and her private parts had been burned chemically, hence the non-stop vulval licking on presentation. She was doing it all the time on the consultation table.

The pest control people had fumigated the apartment twice at 7-day intervals.  They must have exploded a big bomb of chemicals into the apartment and blanketed the whole place with insecticide poison. The dog was contaminated when he walked he floors and licked away the strong smelly poison as best as she could. Her mouth started drooling. She got intoxicated and infected by bacteria as her total white cell counts were raised. Fortunately, she survived the two poisoinings. 

Blood tests cost money and increase veterinary fees. If the dog dies, a blood test will answer some questions regarding the possible causes of death. This result gives some owners and the family members some answers and a closure. Otherwise there might be some doubts regarding the veterinary treatment and competence.