Day 2. Feb 18, 2016. No fever on Day 2. Part 3
Channel: Dr David Sing
Date: 21/02/2016

Feb 18, 2016  10 am. Review at Toa Payoh Vets

Day 2 after treatment, the owner brought back for review. The dog looks more alert and walked. No more fever now. But the very low platelet count, low red cell count and low haemoglobin and blood smear at Toa Payoh Vets showing Babesia in the red celll counts indicated a poor chance of recovery. 

NARRATION AND ILLUSTRATION SAYING THAT BABESIA WAS NEGATIVE WAS INCORRECT ON BLOOD SMEAR. BLOOD SMEAR WAS CONFIRMED POSITIVE BY DR DANIEL.

PLEASE ACCEPT MY APOLOGIES. 

Vet 1 ("hospital") did not think there was tick fever as blood test was normal DURING THE FIRST DAY OF HOSPITALISATION. So there was no scientific evidence to justify the anti-tick fever injection. At Toa Payoh Vets, blood smear showed Babesia in the red blood cells.

On Day 3, the dog had no fever but was not eating.  She vomited copious amount of blood and passed bloody stools. She did not eat and passed away at home. 

The other dog boarded at the same boarding kennel at the same time was normal.  

The dog did respond to the anti-tick fever injection IM as there was no more fever for the next 48 hours.  

Due to the very low platelet count, the dog bled internally and passed away at home on Day 3. Platelet and blood transfusion were advised by Dr Daniel but there was no guarantee that the dog would live after the transfusion. 

This would be an acute case of Babesiosis leading to death. The husband was not happy with Vet 1. A dog with high fever after boarding could indicate a probability of tick fever even though the dog had NO ticks on the body at the vet.

The boarding kennels can never be free of ticks as there are many dogs being boarded, some being stray dogs. 

From this experience, it may be best to do a blood smear for Babesia whenever a dog has very high fever and diarrhoea, especially after boarding. There may not be Babesia in the red blood cells at the time of admission at Vet 1 on Feb 15, 2016 as the Babesia parasitaemia may not be present. 

It may be good practice to give an anti-Babesia injection but much depends on the individual veterinarian's judgment and the practice of evidence-based medicine. 

The husband was not happy with the outcome as the dog had died and the diagnosis was tick fever.