D. E. Larsen, DVM
It is another hot August day in Sweet Home, and fleas are eating most of the dogs alive.
Returning from lunch, I could see that Dixie had started the sprinkler on the roof already. That helped keep the clinic cool. The water would run hot, coming off the roof.
Joseph was waiting with a worried look on his face. He was holding a limp Domino.
Domino was a little five-pound chihuahua. He was black as a young dog but was half gray now.
Dixie herded Joe and Domino into the exam room as soon as I put on my smock.
“He is not doing so good this morning, Doc,” Joe said. Joe was in his early seventies and had lost his wife several years ago. Domino was about all he had left in the world.
We place Domino on the exam table on a fleece. I pulled up his lip, his membranes were white. I looked at his lower back and ventral abdomen, and he was literally covered with fleas.
“Joe, Domino is being eaten alive with fleas,” I said. “I am going to run a quick CBC on him. I can see that he is anemic, we just need to know how bad.”
After we drew a small tube of blood, I discussed the flea situation with Joe as I waited for results. The in-house blood machine would only take a few minutes.
“I don’t know why he would have so many fleas,” Joe said. “He has had a flea collar on since the first of the month.”
“It is a little complex, Joe,” I said. “You have probably had fleas laying eggs in the house all winter and spring. That flea collar might work a little around his head and neck, but for the most part, that little cloud of protection is about three feet behind him. When the weather gets hot, all the fleas come alive, and for a little guy like this, they suck the blood right out of him.”
The CBC showed a packed cell volume of less than 6% and a hemoglobin of 1.6 gm/dl. I don’t think I have seen levels this low in a living dog.
“Joe, Domino is very critical,” I said. “I need to get some blood into him right now. Any undue stress and he could drop dead in an instant. We will need him for a couple of hours, and I will talk about what we need to do when you pick him up.”
Luck was on Domino’s side, we had Riley in the clinic today. Riley was a large mixed-breed dog weighing over 100 pounds. I got ready to collect blood while Sandy called Riley’s owner.
“We have an emergency with a little chihuahua. We need to give him a blood transfusion,” Sandy said into the phone. “We only need about 35 ccs of blood and would like to collect that from Riley, if that is okay. That is a small enough volume that Riley won’t miss it.”
They consented, of course, and I drew the blood into a heparinized syringe. Then we turned around and administered to Domino via a jugular catheter. The risk of a transfusion reaction on an initial transfusion was low, and Domino’s blood values dictated immediate blood.
The result was almost instantaneous. Domino came alive again. His membranes pinked up, and he sat up and looked around as if to ask, “Where am I?”
I gave Domino a Capstar tablet. This was a new pill that provided close to a total flea kill in 30 to 60 minutes. I also gave him some oral Prednisone to reduce the inflammation in the skin.
When Joe returned, we had him fixed up with some topical Advantage for flea control, and I spent some time discussing year-round flea control. In the old days, we would have needed to use a flea bomb in the house, but those were almost impossible to find. The newer products did a good enough job that we did not have to treat the home.
“The important thing to remember is to maintain flea control all the time, year-round,” I said. “In August, when it turns hot, I probably spend 90% of my time treating dogs and cats with skin issues. And most of those issues are caused by fleas.”
“Okay, Doc, I don’t want to lose this guy,” Joe said. “I would have never thought that fleas could do that to a dog.”
“It all depends on the dog,” I said. “Domino is not much of a dog compared to Riley, his donor. Riley weighs over 100 pounds, and fleas could not do that to him. But Domino should be okay now, you just bring him by next week, and I will recheck that blood, just to make sure he is doing okay.”
Joe left with Domino in the crook of his elbow. Domino standing on his front feet, trying to lick Joe’s face. One happy ending.
Dixie had the next patient ready in the exam room. An older lady, who I had not seen before. Doris had a poodle, Daisy, who was scratching on her tail head, that area on the low back above the tail. This was the textbook appearance for Flea Allergy Dermatitis.
“Daisy has been scratching herself raw,” Doris said.
I looked Daisy over from head to tail. Everything looked fine except for the skin. Daisy had a ribbon in her hair on both ears, she had probably just come from the groomer. I ran my hand over the sparse hair on her low back—fleas scattered in all directions.
“Doris, this pattern of hair loss is what we see with Flea Allergy Dermatitis,” I said. “We need to use some medication along with some flea control, and this will clear right up.”
“I overheard your conversation with the gentleman who just left,” Doris said. “I want you to know, Doctor, Daisy does not have fleas, and there are no fleas in my house. The groomer thinks this is a food allergy.”
I promptly parted the hair on Daisy’s back again and quickly captured a flea. I placed the flea on the exam table and squished it with my thumbnail. I didn’t say a word.
“We had to wait out there in your waiting room for almost ten minutes,” Doris said.
“We just happen to have a new veterinary dermatologist that has started practice in Eugene,” I said. “She would be the one who you should see to handle Daisy’s possible food allergies. I will send your records down to her and send you home with her telephone number. I think that she will be able to get you right in to look at Daisy since she has just started practice.”
Doris and Daisy left with the information.
“That was quick,” Dixie said.
“I am too tired to spend my time talking to a brick wall,” I said. “The Dermatologist can tell her it is a flea problem after she does $500.00 worth of skin testing. I am sure she will believe her then.”