• Species: Canine
  
• Age: Almost 13 years old
  
• Sex/Neuter status: Female/not neutered
• Breed: mother Yorkshire Terrier, father Japanese Spitz
  
• Body weight: when she was sick, around 1.7-1.9kg, 2.3kg when health
  
• History: coughing revealed cardiac hypertrophy, heart disease started taking medicine from B2 to C.
  
• Clinical signs: the last time for vet was because she was being weak and couldn't eat, and suddenly hard to walk straight, at night I found her eyes tremor, everything was similar with vestibular syndrome.
  
• Duration: she was unwell almost a week, went to different vet, last time was under 5 hours and she passed away.
  
• Your general location: Asia
  
• Links to any test results, X-rays, vet reports etc. that you have: Hematology and X-rays is under this post.

I am not a professional. She has become a little angel, but there are some issues with this report. Any opinions or suggestions are appreciated, thank you. (There is no abdominal ultrasound file; they said the file has been deleted, with no retention. At that time, her heart disease was at CDVD stage C, and she had been taking medication. However, she suddenly became very weak. At midnight, I noticed she had eye tremors. I found a veterinary hospital that has treated small dogs with vestibular syndrome (although it was not the same veterinarian who took care of her). That was the first time we went to that veterinary hospital. The veterinarian said that she passed away while he was at lunch...)

Symptoms:
Low body temperature of 36.3°C and blood pressure of 60 when admitted to the hospital, close to a shock state.
Diagnosis:
PE: dehydration, low blood pressure, low body temperature.
Hematology: WBC 6.88, HCT 48.15, PLT 249.
Blood biochemistry: AMY 3106, BUN 250, Ca 6.7, PHOS 32.1, CRE 10.3, K 8.7.
4-in-1 rapid test: negative.
X-ray: enlarged cardiac silhouette, mild pulmonary edema. Abdominal ultrasound: excluded pyometra, abdominal bleeding, kidney bladder stones.

Medication list:
Due to severe dehydration, a subcutaneous infusion of RS 60cc was given at the clinic first.
Due to severe hyperkalemia (K>8.5), calcium gluconate 50mg/kg was administered intravenously and slowly pushed for 15 minutes. Due to a history of heart failure and pulmonary edema image, an ICU oxygen warming ward was arranged immediately.

Doctor's supplement:
The cause of death was speculated to be severe renal failure complicated by hyperkalemia, resulting in hypotensive shock.