This dog owner in her 50s with 2 children is one of those natural story tellers. She not only could tell stories very well but the way she acted and told it was a master performance.

"I was alone in the house when the 2nd attack occurred," she said when I asked about her two domestic workers. "I rolled up a carpet,  pick up XXX (the dog being attacked). Yet TTT held onto the left ear and chin of her sibling till gravity pulled TTT down to earth.

"Did TTT bite you?" I asked.

"No, she growled at me." the woman said. "That is why I boarded TTT
at your Surgery after the attack." TTT sounded like a ferocious Jack Russell and I took precautions of muzzling TTT for examination after the attack. Today was some 2 weeks later. The lady had now diagnosed shingles infection linked to the dog attack, according to her diagnosis. This is what she said to me.  

"Two days after the attack, I saw a circle of 'insect bites' on my right lower elbow area." She displayed her wounds on the inner side of her elbow joint. They were now maroon red with a black centre in the bigger wound. 

"Are you sure that the circular line of wounds were not caused by TTT biting you?"
This would be my first diagnosis although I am not a medical doctor.

"Well, TTT's teeth was sunk into XXX's left ear. I held XXX up till TTT had to let go as gravity pulled her downwards.  So, she could not have bitten me."
The lady waved her hand up and down to show that she had held XXX high up, until TTT gave up to the forces of gravity and dropped to the ground.    

"The next day, I felt tired," the lady continued. "Tingling sensations rippled from under the skin of my right elbow to my back shoulder", she pointed to her back. "More rashes appeared in the area. Watery blisters formed. The tingling sensation was unbearable. I quickly went to consult Dr Thiru, the famous skin specialist. Do you know him?"

"I don't know him nor have I met him," I said. "Is he the distinguished looking man with silvery grey hair and white sideburns?" I had attended a talk given by Attorney General Walter Woon's lecture "Criminal Aspects Of Medical Practice" to a full house of at least 1,000 doctors and lawyers in the Supreme Court Auditorium on Nov 30, 2009. The moderator was a doctor who is a skin specialist. "Yes," she confirmed my description of the good doctor.

"The doctor asked whether I had been to the vet?" the woman commented. "Probably my doctor was thinking that my right elbow I had been infected at your Veterinary Surgery."

I don't think the good doctor would have thought that she was infected by putting her elbow on the veterinary examination table and got infected by Shingles. I don't know why he asked whether she had visited the vet earlier.

"So, did he prescribe you the antiviral drug?" I was more interested on the cure. 

"He said to wait 3 days," the woman replied. "Then more rashes appeared. They become watery and burst. I felt tingling, as if some snakes were travelling up my hand to behind my back and forth. I quickly went to see him. He was not available but his colleague gave me the medication. Now I feel so much better and have the time to quickly get my 2 dogs vaccinated."

"My sister had shingles." I said. "The viruses travelled along her nerves in her leg and the serpentine lesion manifested as snake-like in appearance."

This woman did not have the serpentine tracks as she had sought prompt medical treatment. "If the virus completes the travel from one end of the nerve, go round the body, the person will die," the lady told me about a common Chinese belief. "That is why the Chinese temple medium used incense to burn the shingles skin. To kill off the head of the snake."

"Some Singapore people don't know what is the cause of this serpentine skin problem," I said. "So, they seek the help of Chinese mediums."

The lady enlightened me: "Actually, shingles is the re-activation of the chicken pox virus due to stress. The virus lurks in the body for a lifetime. It is extremely painful, itchy and causes tingling sensations." 

This lady is surely knowledgeable about shingles. I just could not believe that separating two dogs in a fight would lead to a shingle infection as this lady was definitely in good health.  I believe that there is a remote possibility that TTT had bitten her right elbow when the dog loosened her grip on XXX and was falling down to earth. I mean, how would the lady know since she was highly agitated and in that instant, TTT's bite would have resulted in what she first told me as "circular rashes" in a small area in the inner aspect of the skin of her right elbow. I remembered asking her to repeat what she said. She said "circular rashes".

She meant that she had rashes clustered in a circle. Or semi-circle. The pain and tingling sensations could be due to the spread of micro-organisms along the nerve and tissues originating from the bite wounds. This condition is documented in the skin to owners owners who had been scratched by the cat. 

These bite rashes from the upper and lower incisor teeth of the attacking dog would become infected. That could be the reason that the first doctor did not think this was a shingles infection. As for the appearances of more rashes in the surrounding area, it could be due to the scratching of the infected skin. This is my hypothesis which I am sure the lady would not agree.  I have not seen shingle infections in human beings. Maybe they manifest as rashes clustered in the circle too.     

Medicine is full of diagnostic mysteries. I asked to see the inner or medial aspect of the elbow again. I could see that the rashes covering an area of 10 X 10 cm of skin in the elbow. The biggest rash was 8 mm in diameter. It had a black centre. Other rashes were healing.

This is an incredible but true story of an apparent shingles infection linked to dog assault.  Did the attacking dog get any shingles as well?  She had really blood shot eyes. Red sclera in both eyes after her ferocious lunge for the jugular of the sibling who garnered more attention at home. The redness in both sleras persisted for several days. So, would this be caused by a virus activated by the high stress of trying to get rid of the rival in love? A latent herpes zoster-equivalent virus in the dog, a canine type of chicken pox virus that gets reawakened in times of high stress? This dog was lunging for the jugular of the sibling with only one intention. To kill a rival in who is favoured more by family members.  But her attempt was thwarted and now she was "in the doghouse". Or to be precise, waiting to be rehomed (Re-homing picture must be attractive).  

P.S.
1. Herpes zoster (Shingles). Anybody who has had chicken pox is at risk for developing shingles many years later. The chicken pox virus lies dormant in the person's body. Stress or a decreased immune system reawakens the virus, resulting in shingles infection. It appears as a rash. Rashes cluster around the eyes, face or body. The Shingles infection is also called herpes zoster. It is an extremely painful and itchy condition. Early aggressive treatment with antiviral drugs can lessen the length and severity of shingles attack.

2. Red scleras in the dog. I had encountered a few cases. Some are due to traumatic injuries. Some are a result of intense rubbing of the eye arising from some chemical spills. I note that there is a dog owner posting a picture of his dog with red sclera in a local website called Stomp.

I had 2 memorable cases of red scleras in Jack Russells.
2.1 This Jack Russell had a chew rope stuck inside its colon for some time.
2.2 This Jack Russell had intense abdominal pain and was vomiting. Exploratory laporatomy revealed petechial haemorrhages in the pancreas.
This present case would make it 3 memorable cases of Jack Russells with blood-shot eyes. E-mail to judy@toapayohvets.com if you have seen more cases.