Strange case

I saw something this weekend that I have not seen before. A mixed breed, 50ish pound dog presented to me for a "swollen leg." When my tech brought the dog, "Frisco" back to the ICU, I noted that indeed, the leg was massively, massively swollen. It was approximately 4 times the size of the other leg. It was also hot but not particularly painful to touch.

Frisco was a total freakazoid - growling, snapping, and defecating, so he wasn't easy to examine. I couldn't get a peek at his gum color without sacrificing a few fingers, something I am generally unwilling to do. When restrained, he urinated on my technician in defiance and fear. He was not a nice dog.

When I went to talk to the owners, they explained that Frisco had been diagnosed with hemophilia 2-3 years ago. The same problem had occurred. His leg was became massively swollen, and he started limping. The owners waited 3 days to see their veterinarian, and by then, Frisco was weak, lethargic, and had labored breathing. Turns out, he had lost a massive quantity of blood into the tissues of his leg. A blood transfusion and supportive care later, he was normal.

The same thing was happening now. From the quick glance I got at his gums (under the muzzle), he was paler than I would like. A PCV measured at 24%. Certainly not life-threatening anemia. Not yet, anyway. He didn't need a blood transfusion, but he did need a fresh frozen plasma transfusion. This would provide his body with the clotting factors that he was naturally lacking.

Unfortunately, the owners had severe financial limitations and could not afford our estimate. On the bright side, it was late Sunday evening (11pm). They planned on being at their vet's doorstep at 8am sharp. I explained that I could not guarantee that their dog wouldn't bleed to death during the next 9 hours. They understood and took the risk. I'll let you know what happened when I find out...