Physical exam revealed muffled heart sounds, pale mucous membranes with some blood in the mouth from coughing.
Chest x-rays revealed a lot of fluid in the chest, almost obscuring the heart and partially filling the lungs.
An activated blood clotting time was performed which demonstrated a lack of clotting ability.
After further discussion the possibility of exposure to rodent poison in the past month was a possibility. Which helped to confirm our diagnosis of acute hemorrhage into the chest.
Anti coagulant toxicity's are often treated with long term Vitamin K1 alone. However, Jill was in a crisis and would bleed to death before Vitamin K1 therapy could be effective.
A plasma transfusion was indicated to immediately replace her clotting factors. This was done over several hours along with initial vitamin K1 therapy. Within several hours her bleeding had subsided
and clotting time was normal in 4 days. Jill was maintained on oral Vitamin K1 for 1 month along with instructions to avoid exertion. Fortunately, the combination of a concerned owner, timely
diagnostics and emergency therapy by the Heritage staff made for a happy ending for Jill and her family.
