17 Lead ingestion in a puppy
Initial presentation
Signalment: 5-month-old entire male West Highland white terrier, body weight 3.1 kg
Case history
The puppy had been vomiting bile and occasionally digested food once a day for 4 weeks. Two weeks prior to consultation he had a seizure which was described as beginning with barking and running around the room before becoming recumbent, unconscious, salivating and paddling. The episode was thought to have lasted about 10 minutes. There had been no further seizures.
The owner thought that the puppy’s appetite was reduced and the puppy was reportedly more flatulent. His stools were reported as normal in consistency, but only passed every other day. The puppy’s drinking and urination were unchanged.
The puppy did play with toys and the owner did not know if he could have ingested any of them.
The owner had owned the patient and his litter mate since they were 12 weeks old and the other puppy appeared healthy. The affected puppy was smaller than his littermate. Both puppies were fully vaccinated and had been de-wormed with fenbendazole several weeks prior to presentation. Both puppies were fed a commercial puppy food supplemented with commercial ‘puppy milk’, chicken and rice. They had not travelled out of the United Kingdom.
Physical examination
The puppy was alert and responsive, but quieter than normal for a 6-month-old terrier puppy. His body condition score was 4/9. His mucous membranes were pink and moist with a capillary refill time of <2 seconds. His heart rate was 152 beats per minute with matched good quality pulses. Respiratory rate was 28 breaths per minute and thoracic auscultation revealed no abnormalities. Abdominal palpation was unremarkable, as were his peripheral lymph nodes. Rectal temperature was 38.6° C.
Problem list and discussion of problems
Differential diagnosis
Differential diagnoses for vomiting
Differential diagnoses for seizures
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