“My mom is going to kill me,” said my young client. He was watching his mother’s poodle, Chalmers, while his mom was in Seattle taking care of her grandkids. He’d just had Chalmers groomed for the first time in a long while. Chalmers had been so matted that the groomer had to shave him down. My client figured that his mother would be away for another two weeks and hopefully some of the hair would regrow.
Today, he noticed two large bruises along the dog’s abdomen. He didn’t notice them after the grooming, but he admits that all he kept thinking about was that Chalmers was naked and was praying that the hair would regrow quickly.
“I think that the groomer hurt him,” said my client. I was listening to him and hopefully I was empathetic toward his concerns for Chalmers, but I have seen this type of bruising before. Especially after grooming.
I opened Chalmers’ mouth, and his gums were pale pink, and I rubbed my fingernail against his gums and they started to bleed. I also looked into his eyes and there was a scant amount of blood in the exterior chamber of his eye. The rest of Chalmers’ examination was normal other than he had a fever of 103 and his lymph nodes were enlarged. I asked my client if it was OK to run some diagnostic tests, and he agreed.
My client wanted X-rays to document if there was any abuse, and I told him that I would, but after the bloodwork. My client and I had about a 10-minute discussion on what could have happened at the groomer that would have left the area around Chalmers’ abdomen the color of Merlot. I asked him if he had looked at the skin prior to the grooming. He said he didn’t and probably couldn’t, because of how matted Chalmers was. He guessed that it had probably been a year since Chalmers’ last groom.
I told my client that the lesions didn’t look like abuse. The combination of bruising, friable gums that bled excessively, fever, and enlarged lymph nodes can be signs of tickborne disease or autoimmune disease, which I asked the technicians to test for. The client told me that Chalmers used to have ticks, but he hadn’t seen them in a while. I did remind him that Chalmers had been extremely matted, and it was possible that he wouldn’t see them directly on the skin.
My client was skeptical of the groomer. “So why the bruising after the groom?” he asked. I told him it was just like when I rubbed Chalmers’ gums and made him bleed. It’s the same thing with the groomer. If Chalmers has a low blood platelet count, then blood clotting will be compromised. Brushing and shaving can be traumatic to the skin; just as you will see with any person on anticoagulants for atrial fibrillation, the person’s skin will bruise when touched. My client smiled and said that his grandfather constantly had bruised skin since starting warfarin for A-fib.
My technician came into the room and told me that Chalmers was anemic with a platelet count of under 100,000 when over 300,000 is normal. The coagulation profile would come back later, but they tested him for ehrlichiosis, and he was positive. They also found a dead tick in his ear.
My client wanted to know what my plan was because he needed to call his mom. I told him that we were going to start Chalmers on doxycycline for now and wait for the rest of the bloodwork to come back later. I also told him to tell his mother that the grooming might have saved the dog’s life by allowing us to notice a clinical sign of infectious disease before it was too late.