Case report: A 5-year-old golden retriever with IDA
Jun 01, 2014
Sam, a 5-year-old 54.3-lb (24.7-kg) male golden retriever, was presented for evaluation of a four-week history of intermittent vomiting and anorexia, mild lethargy, and dark stools.
This hunting dog was adopted as a puppy. His initial growth was slower than his littermates' growth. When Sam was 1 year old, a jejunal resection and anastomosis was performed to correct a congenital stricture.Physical examination and initial diagnostic tests
Additional diagnostic tests
A 250-ml packed RBC transfusion was administered, which raised the patient's packed cell volume to 33%. Gastroduodenoscopy was performed. No gross abnormalities were detected. Biopsy samples were collected from Sam's stomach and duodenum.
Sam was treated with a single intramuscular injection of iron dextran (13 mg/kg) followed by two months of ferrous sulfate (250 mg orally once a day). Follow-up diagnostic test results showed a normal packed cell volume (43%), a normal mean corpuscular volume (68 fl), and an improved mean corpuscular hemoglobin concentration (36.6 g/dl).
This case is an example of IDA secondary to chronic GI blood loss. Although the initial laboratory findings were highly suggestive of chronic hemorrhage and confirmed iron deficiency, the cause of the blood loss was not easily identified.
Minimally invasive diagnostic tests, including abdominal ultrasonography and gastroduodenoscopy, failed to identify the source of hemorrhage. This case highlights the role of an exploratory laparotomy in the work-up of chronic intestinal bleeding and the limitations inherent in examining only the serosal surface of the bowel.
The decision to resect the previous surgical site was appropriate and was made because no other abnormalities were evident. Although the underlying cause of the defect at the previous anastomosis is unknown, Sam did well after this surgical resection and iron supplementation.