Pitting Edema After Fall In Vet's Office- Please Help

[Guest Dogwood235]

Hi and thanks for reading this post. I'd be grateful for advice and opinions. I'm sorry this post is so long, but I am so tired, scare and confused that I just don't know what details are important at this point.

 

My girl Bella is 9 years old and I admitted her into the vet hospital Tuesday morning for what turned out to be HGE (hemorrhagic gastroenteritis). I have seen several posts on here about HGE and this post isn't as much about HGE , but I wanted to give some medical background. As alarming as HGE is by its very nature, Bella seemed to be responding well to the treatment of antibiotics until today when her red blood count plummeted down to 20. Right now she is holding at 26 and they told me that 40-45 is normal. They said if she drops below 20 they will transfuse.

 

It turns out that when they were taking Xrays of Bella stomach looking for signs of blockage (which they didn't find), Bella "jumped off the X-ray table". This is what they told me Tuesday evening. It alarmed me but the vet passed over it so quickly and I guess I was so horrified with Bella puking and pooping blood (and now signs of blood in her urine), that I questioned her about the incident, but perhaps not enough. she was very unconcerned about the incident and mentioned that they started her on pain meds b/c her stomach was very sore on the intake evaluation and after her incident on the Xray table they figured she was in pain. I could kick myself now for not getting a straight answer out of them immediately.

 

Wednesday my regular vet called me and said Bella is stable, vomiting is under control but she was still pooping digested blood indicating upper GI problem. Her red blood count and coagulation test were normal. She also said Bella's lower leg was swollen and she was limping and this was the first mention of pitting edema i heard. She also said that they noticed urine in Bella's blood, so they took a sample from her bladder with a needle and they noticed an abnormal amount of bruising associated with the needle puncture. I asked more about her leg being swollen, but again i was more concerned with her HGE and the possibility of a blood or immune problem, so i didn't press the point very hard. I can understand a dog in pain doesn't want to be placed on her back and that she may have kicked out and that technicians may not have been prepared that Bella would do that. She is normally an extremely calm patient. They always remark on how easy she is to work with. When i asked exactly what happened I got a response I would hear more often "i don't know i wasn't in the room" . well, i tried to go visit bella Wednesday night but my tire blew out and my jack didn't lift my Jeep high enough to change the tire... (but that is another story).

 

This morning i get a call from yet a different vet from the same hospital and he tells me that bella is responding well to the HGE treatment. So i say great acn she come home, but she can't because her right left leg is entirely swollen. Now I am thinking and asking "what the hell happened in that Xray room?" He puts me on hold but comes back with no answer but saying that it is bad enough that they need to keep her for two more days to monitor, treat it and give her pain meds. Yes i agree with him but this happened while under their care and I cannot be expected to pay for a two day stay in the hospital for something they are responsible for. He agrees, that if she gets better in two days then her pitting edema was result of trauma and they will not charge me for the services but if her pitting edema doesn't get better in two days then their is an underlying cause and then they are going to charge me for it. that evening her red blood count falls from 40 to 20 and they say they may need to transfuse. When i got to see her at 9:00 pm she was rebounding slowly and her RBC was 26. All her labs were normal except for high white blood cell probably b/c of the HGE and possible start of a urninary infection. All they keep impressing up on me is that pitting edema is not a normal response and that it indicated something else is going on with my girl. Is this true? Is pitting edema ever a normal response to trauma??

 

I am asking GTers for help. I am so tired from worry, crying, not sleeping, cleaning blood off my carpets and helping my SA hound Charley deal with the fact that Bella is gone, that I feel like I cannot see the situation clearly anymore. I am so scared of an underlying problem for Bella becuase they mentioned cancer more than once, and they mentioned autoimmune, blood disorders... you name it they mentioned it... and now I am concerned that my vets are not being toatlly forthcoming with me about what actually happened in the Xray room and I'm totally irritated with myself that I haven't taken a more definitive stance and demand to know what in the HELL happened in that Xray room. I saw bella tonight. She is all red and bruised on the inside of her right leg ... the whole right leg up to her little tail and across the top of her tail is swollen so big. AND her LEFT leg is swelling too. this they did not tell me. Her left hock is swollen. She is so frail, she lost a lot of weight. My poor Bella. She is the sweetest girl. I know one thing... they are going to find the two people who were in that Xray room and get me an answer on what happened in there. I can understand that accidents happen, but i have a right to know what happened. I have never seem swelling like that in my life. I want my girl back happy and healthy.

[iluvgreys]

OMG. I'd be worried sick, too. You're right to press for details about the x-ray incident. I've never seen pitting edema with a fall. Have they x-rayed the leg to be sure there wasn't a break? What about a blood test for clotting disorder? Dr. Couto at OSU would be a great resource as he's doing some research into gh blood disorders, and might have some useful advice for you. Could you fax him Bella's blood work results? Sending lots of prayers and light to your poor girlie and her unhappy bro, Charley.

[Guest Dogwood235]

OMG. I'd be worried sick, too. You're right to press for details about the x-ray incident. I've never seen pitting edema with a fall. Have they x-rayed the leg to be sure there wasn't a break? What about a blood test for clotting disorder? Dr. Couto at OSU would be a great resource as he's doing some research into gh blood disorders, and might have some useful advice for you. Could you fax him Bella's blood work results? Sending lots of prayers and light to your poor girlie and her unhappy bro, Charley.

 

thank you so much. I asked them if they considered Xraying her leg to see if it was broken but they said if it was broken she wouldn't be using it. They testing her coagulation and said it was normal. I was really shocked when i saw Bella tonight, my poor girl. She had a spinal stroke just this january that effected her hind end and left her with permanent nerve damage to her left rear leg. She has been through so much.

 

Thanks for the advice on contacting Dr Couto. I am going to look for him online.

[Guest Spiff]

No advice to give, but I'll be thinking of you and Bella and hoping that she starts feeling better VERY soon!

:grouphug :hope

[Guest Dogwood235]

No advice to give, but I'll be thinking of you and Bella and hoping that she starts feeling better VERY soon!

:grouphug :hope

 

thank you very much. I appreciate you posting. i hope so too

[Lilysmom]

I agree, something is not right here. Defiantely press for all the details of what happened. There are others here who have had their greys treated for the bleeding disorder (I can't remember what it's called). Definately contact Dr. Couto.

 

Take a deep breath.

 

I'm sorry you and your pup are dealing with this.

[Lilysmom]

Here is contact info for Dr. Feeman

 

Dr. Feeman

 

Dr. Bill is very nice and so willing to help.

 

Karen

[feemandvm]

I would tend to think that the "jumping off the x-ray table" probably has little to do with any of Bella's signs. Of course as you have heard many times "I wasn't in teh room" so obviously I can't know that... but the pitting edema is not a typical response to trauma. It often is a response to vasculitis. With HGE we actually normally see an elevated red blood cell count due to dehydration even though they have very bloody stool so obviously a low red blood cell count is unusual.

 

I assume from the history that the coagulation test was done on Tuesday or early Wednesday? Based on the history I would have some concerns for disseminated intravascular coagulation (DIC). However, I would have expected the coagulation panel to be abnormal if that was the case (unless the coagulation panel was done before the DIC started).

 

I would highly encourage you to ask your vets to contact Dr. Couto at OSU (or if he is out of the office someone in the Greyhound program). The general number for OSU is 614-292-3551. From there voice mail will get them where they need to go (there is a number for vets to push... I just don't remember which one). Dr. Couto has done a lot of research on bleeding Greyhounds and is probably the best resource available.

 

Are the platelets also dropping with the red blood cells? Is the BUN elevated which would also indicate an upper GI bleed? Has she had any black tarry stool or has the stool always contained frank red blood? Have they discussed doing tick titers with you at all?

 

 

 

 

 

[Guest Dogwood235]

I would tend to think that the "jumping off the x-ray table" probably has little to do with any of Bella's signs. Of course as you have heard many times "I wasn't in teh room" so obviously I can't know that... but the pitting edema is not a typical response to trauma. It often is a response to vasculitis. With HGE we actually normally see an elevated red blood cell count due to dehydration even though they have very bloody stool so obviously a low red blood cell count is unusual.

 

I assume from the history that the coagulation test was done on Tuesday or early Wednesday? Based on the history I would have some concerns for disseminated intravascular coagulation (DIC). However, I would have expected the coagulation panel to be abnormal if that was the case (unless the coagulation panel was done before the DIC started).

 

I would highly encourage you to ask your vets to contact Dr. Couto at OSU (or if he is out of the office someone in the Greyhound program). The general number for OSU is 614-292-3551. From there voice mail will get them where they need to go (there is a number for vets to push... I just don't remember which one). Dr. Couto has done a lot of research on bleeding Greyhounds and is probably the best resource available.

 

Are the platelets also dropping with the red blood cells? Is the BUN elevated which would also indicate an upper GI bleed? Has she had any black tarry stool or has the stool always contained frank red blood? Have they discussed doing tick titers with you at all?

 

Thank you!!! thank you thank you!!! yes I was told about the coagulation test being normal wednesday morning. Actually my vet said they repeated it becuase the initial values were so ridiculously off the mark ( i don't know how) that no one believed it so they repeated the test.

I think her platelets were normal but her WBC count was definatley elevated which they assumed was from the HGE and possibly urinary tract infection, although i have not heard confirmation of the urinary culture.

Bella's stool has consisted of digested blood since Monday. Her vomit was alarming in volume and pure red blood, not flecks, then turning brown.... which they tell me is digested blood. My vets suggested upper GI and today they mentioned transferring her to surgical consult for endoscopy.

and th tick titers... bella had exposure to erlichia and lyme but was treated with massive dose antibiotics. This was at least a few years ago.

 

I will definately have my vets contact Dr. Couto at OSU and I cannot thank you all enough for your support. My trust in my vets was a bit shaken b/c they were not forthcoming with me about her problem in the Xray. I have been going to that office for over 10 years and would have expected different behavior from them. but your posts make me realize that the problem in Xray is insignificant to her case and thats why the vets were dismissive. I guess since they told me they would see if her edema got better over time, then they would know it was trauma... it just didn't sit right. Maybe they just don't know what is happening to her. At any rate, thank you and I will keep you posted.

 

i am going to try and get an hour of sleep before i have to get up and go to work.

 

[Guest vahoundlover]

How scary! I have no advice, other than pushing your vets to contact OSU asap. Sending many prayers Bella will be ok.

[Lilysmom]

I would tend to think that the "jumping off the x-ray table" probably has little to do with any of Bella's signs. Of course as you have heard many times "I wasn't in teh room" so obviously I can't know that... but the pitting edema is not a typical response to trauma. It often is a response to vasculitis. With HGE we actually normally see an elevated red blood cell count due to dehydration even though they have very bloody stool so obviously a low red blood cell count is unusual.

 

I assume from the history that the coagulation test was done on Tuesday or early Wednesday? Based on the history I would have some concerns for disseminated intravascular coagulation (DIC). However, I would have expected the coagulation panel to be abnormal if that was the case (unless the coagulation panel was done before the DIC started).

 

I would highly encourage you to ask your vets to contact Dr. Couto at OSU (or if he is out of the office someone in the Greyhound program). The general number for OSU is 614-292-3551. From there voice mail will get them where they need to go (there is a number for vets to push... I just don't remember which one). Dr. Couto has done a lot of research on bleeding Greyhounds and is probably the best resource available.

 

Are the platelets also dropping with the red blood cells? Is the BUN elevated which would also indicate an upper GI bleed? Has she had any black tarry stool or has the stool always contained frank red blood? Have they discussed doing tick titers with you at all?

 

Thank you Dr. Feeman for replying so quickly, I was racking my brain like crazy trying to remember if there was a name for the bleeding in greyhounds. I knew this owner was frantic and needed encouragement or any advice you could offer. Other than Dr. Couto, you were the next person I could think of to have her contact.

 

Thanks again! GT is so very fortunate to have such wonderful willing souls to answer our questions and to help calm our fears.

 

Karen

 

[Burpdog]

Sending lots of prayers.

[Greytlady94]

Sending prayers for Bella.

[MP_the4pack]

I would take her to another vet. THings just aren't jiving there. And normal RBC for greyhounds is in the 60's not 40's. (which is why they make such terrific blood donors)

So 20's is majorly low.

 

Now, I have a girl who has had 3 episodes of edemedous legs. Two were cause by injury, one is uncertain but there was a bite or rash in the area before the leg swelled. She has a very bad heart and is on a plethura of meds. Since I have been able to clear up the swelling with antibiotics and wrapping I haven't pursued it much other than contacting the vets initially. But the next time it happens she's going to a specialist.

But unfortunately it could be related to her heart problems and decreased circulation.

 

I think injury can cause the swelling but because there is another underlying problem.

 

 

 

[Aerosmom]

I hope you hear from OSU soon. I would aggressively try to find out what's wrong with your pup. Sending lots of prayers for Bella.

[Guest Dogwood235]

I would take her to another vet. THings just aren't jiving there. And normal RBC for greyhounds is in the 60's not 40's. (which is why they make such terrific blood donors)

So 20's is majorly low.

 

Now, I have a girl who has had 3 episodes of edemedous legs. Two were cause by injury, one is uncertain but there was a bite or rash in the area before the leg swelled. She has a very bad heart and is on a plethura of meds. Since I have been able to clear up the swelling with antibiotics and wrapping I haven't pursued it much other than contacting the vets initially. But the next time it happens she's going to a specialist.

But unfortunately it could be related to her heart problems and decreased circulation.

 

I think injury can cause the swelling but because there is another underlying problem.

 

 

I'm really very sorry to hear your girl has so much trouble with her heart and with weird swelling as well. were both of her legs edemous? where they pitted edema or regular edema? I have read that regular bilateral edema is also not normal and indicitive of heart problems.. did your vets mention that ? I can't vouch for the internet sources where I get my info, so I think you are wise to bring her to a specialist next time. As much as we all love our hounds and try to protect them from harms way, such is life, isn't it? We do the best we can and hope for the best and wait to see what lies ahead.

 

I agree and so did my regular vet.. i have transported Bella to a internist and asked them to contact OSU which they were very willing to do.

Bella's RBC is steady rising and she was up to 36 yesterday. I am waiting to hear from the new vets this morning. admittedly 36 ain't great but it's better than 25.

The good news is that there are no tumors in her belly or chest, but her kidneys look slightly abnormal. Her urine sample taken from the bladder looked blood red, and they pulled some clear fluid from her abdominal cavity.

 

The new vets are doing Tick serology, von Willebran factor test, testing her abdominal cavity fluid/ cytology, urinalysis and a coagulation profile. Bella was 5 lbs underweight on Tuesday and she didn't look as skinny as she does now. Now with all the swelling she weighs 63 pounds again... which means she is probably carrying more then 5 pounds of fluid in her legs. my poor girl.

 

Bella's spirits are up tho, She is obviously exhausted and uncomfortable but she doesn't appear to be in any pain and she is bright and alert. if her RBC improves today she may come home, which my wallet will thank me for b/c overnight in ICU tops out at around $700. I have no idea how I am going to pay this all off. I was already looking for a second job... i guess i had better go FIND one now.

 

I want to thank all of you GTers for your support. I do not post often b/c i feel i don't often have anything to contribute, but I see now how even a few kind words really helps, plus the experience of GTers and the vets that patrol these posts... it's been a great source of comfort, knowledge and support and I am grateful.

[Guest greyhound1]

[Guest gomiesmom]

thoughts and prayers-- First time poster, but I read a lot - MY 2 3/4 yr old Grey, Gomer, had a dental yesterday and his pre-anestetic blood draw site is Port wine purple and it extends from his foot all the way up his leg and is swollen, like pooling blood down by his foot. He went to the E-Vet last night and they ruled out any clotting disorders. His RBC is 106, which I think is normal for greys, but the vet thinks is low. I am more worried abut his white, as the bloodwork showed at 10.8, which I think is high for Greys.They prescribed Prednazone for the swelling, as well as Doxycyclene....

I am waiting on a call from my regular vet this AM. Please let me know what you find out and I'll do the same.

Thaks,

Gomiesmom

[Burpdog]

Do you mean her RBC or HCT?

 

Sending lots of prayers.

[Guest gomiesmom]

I meant Platlets - sorry - I'm upset about this..... ( PLT is 106,000) Vet says thats low, but per GreytHealth article 80K-200K is normal for a grey - 150K-400K for other dogs.. The RBC is 9.33 and the HCT is 65.9.

 

[MP_the4pack]

I would take her to another vet. THings just aren't jiving there. And normal RBC for greyhounds is in the 60's not 40's. (which is why they make such terrific blood donors)

So 20's is majorly low.

 

Now, I have a girl who has had 3 episodes of edemedous legs. Two were cause by injury, one is uncertain but there was a bite or rash in the area before the leg swelled. She has a very bad heart and is on a plethura of meds. Since I have been able to clear up the swelling with antibiotics and wrapping I haven't pursued it much other than contacting the vets initially. But the next time it happens she's going to a specialist.

But unfortunately it could be related to her heart problems and decreased circulation.

 

I think injury can cause the swelling but because there is another underlying problem.

 

 

I'm really very sorry to hear your girl has so much trouble with her heart and with weird swelling as well. were both of her legs edemous? where they pitted edema or regular edema? I have read that regular bilateral edema is also not normal and indicitive of heart problems.. did your vets mention that ? I can't vouch for the internet sources where I get my info, so I think you are wise to bring her to a specialist next time. As much as we all love our hounds and try to protect them from harms way, such is life, isn't it? We do the best we can and hope for the best and wait to see what lies ahead.

 

I agree and so did my regular vet.. i have transported Bella to a internist and asked them to contact OSU which they were very willing to do.

Bella's RBC is steady rising and she was up to 36 yesterday. I am waiting to hear from the new vets this morning. admittedly 36 ain't great but it's better than 25.

The good news is that there are no tumors in her belly or chest, but her kidneys look slightly abnormal. Her urine sample taken from the bladder looked blood red, and they pulled some clear fluid from her abdominal cavity.

 

The new vets are doing Tick serology, von Willebran factor test, testing her abdominal cavity fluid/ cytology, urinalysis and a coagulation profile. Bella was 5 lbs underweight on Tuesday and she didn't look as skinny as she does now. Now with all the swelling she weighs 63 pounds again... which means she is probably carrying more then 5 pounds of fluid in her legs. my poor girl.

 

Bella's spirits are up tho, She is obviously exhausted and uncomfortable but she doesn't appear to be in any pain and she is bright and alert. if her RBC improves today she may come home, which my wallet will thank me for b/c overnight in ICU tops out at around $700. I have no idea how I am going to pay this all off. I was already looking for a second job... i guess i had better go FIND one now.

 

I want to thank all of you GTers for your support. I do not post often b/c i feel i don't often have anything to contribute, but I see now how even a few kind words really helps, plus the experience of GTers and the vets that patrol these posts... it's been a great source of comfort, knowledge and support and I am grateful.

 

The swelling was at different times, different legs. And the first two times, to the left leg it was an obvious injury involved. However, the injury itself shouldn't have caused that amount of swelling. The last time, just a few weeks ago, it appeared to have been a bug bite on the right. So, there is an underlying problem. We still don't know if it is heart related or another problem.

She doesn't have edema without an insult to the area, but there's a problem that results in severe edema when there is an insult to the area.

 

I hope this help.

 

 

[Guest vahoundlover]

Checking in, Sending prayers your girlie will be home soon and you get some answers.

[Guest jurishound]

Just wanted to add that our beloved Cricket developed pitting edema in one leg and in doing an ultrasound of her abdomen, the vet found a blood clot in her upper thigh, which was believed to be the cause of the edema. You may want to run this possibility by the vet. Good luck - I hope this resolves quickly!

[Guest Dogwood235]

thoughts and prayers-- First time poster, but I read a lot - MY 2 3/4 yr old Grey, Gomer, had a dental yesterday and his pre-anestetic blood draw site is Port wine purple and it extends from his foot all the way up his leg and is swollen, like pooling blood down by his foot. He went to the E-Vet last night and they ruled out any clotting disorders. His RBC is 106, which I think is normal for greys, but the vet thinks is low. I am more worried abut his white, as the bloodwork showed at 10.8, which I think is high for Greys.They prescribed Prednazone for the swelling, as well as Doxycyclene....

I am waiting on a call from my regular vet this AM. Please let me know what you find out and I'll do the same.

Thaks,

Gomiesmom

 

I'm so sorry. I understand your worry. How did they rule out clotting disorders? did they do a clotting test? Von Willebrands factor test? Tick Panel? I'd be interested in what tests they did to rule it out.

 

My girl just tested positive again for Lyme and Erlichia (which she had before and was treated with doxycyclene). The lyme was weakly positive like before but the lab is re-doing to erlichia titre which my vet says they usually do to confirm a positive. One theory of my vets is that it is a chronic stage of a tick disease.

 

I am waiting for my vets to contact osu and for the results for more tests to come back.

 

keep me posted and thanks

[Guest Dogwood235]

Just wanted to add that our beloved Cricket developed pitting edema in one leg and in doing an ultrasound of her abdomen, the vet found a blood clot in her upper thigh, which was believed to be the cause of the edema. You may want to run this possibility by the vet. Good luck - I hope this resolves quickly!

 

thank you!! Poor Cricket!

 

Bella had a chest Xray and ultrasound to rule out cancer... which fortunately they have. they didn't find anything unusual except for her kidneys.

 

They are considering that she may be throwing lots of small clots. At this point its a lot of wait and see but the good news is that my girl is home and that her swelling has decreased slightly on her left side and across her back.

 

The swelling was at different times, different legs. And the first two times, to the left leg it was an obvious injury involved. However, the injury itself shouldn't have caused that amount of swelling. The last time, just a few weeks ago, it appeared to have been a bug bite on the right. So, there is an underlying problem. We still don't know if it is heart related or another problem.

She doesn't have edema without an insult to the area, but there's a problem that results in severe edema when there is an insult to the area.

 

I hope this help.

 

I'd be interesting in what kind of testing they have done for your girl to rule out other things. Has she had this problem as long as you have had her or has it developed over time?